Beta Blockers

Hello, Joyce,
I was diagnosed with HOCM over twenty-five years ago. Never had symptoms. I take 100 mg Metopolol am & pm for high blood pressure. I also take Camzyos (started in Oct. 2025). I am female, 74 years old and still working.
I understand 100 mg twice a day to be quite a high dosage but blood pressure doc does not want to cut it back as I also have a high heart rate...usually 90+ per minute. Per your question about side effects, it makes me super tired....like many of us, I just try to keep going! Wishing you well, blessings!

@christine270 - thank you! I appreciate your reply. It helps me to consider my options. super tired must be tough for sure. I am still working as well - just not nearly as hard or as much. I had no clue that I had HOCM until a murmur was heard about 2 years ago.

I was prescribed Metaprolol 50mg on 2/26/2026 - 1 pill every night before bed. For two weeks it seemed to really bring me down - I felt fatigue and like I was just a little "off". Around 3/10 those feelings began to level off or even out. Walking now I don't feel as much shortness of breath and overall the effects of the drug have been tapered. I need to check my blood pressure a bit more often, I'm a little high, but not too bad. I just turned 68 and this is the first prescription drug I've had to take aside from antibiotics and albuterol for an incorrect diagnosis of asthma. Overall, I think it's been positive....

Hello @joycehocm! Please do ask your cardiologist HOW Metoprolol would affect the symptoms you are experiencing. I was on Verapamil, a calcium blocker before a Septal Myectomy (age almost 76 in 2022). I was prescribed Metoprolol Succinate 50mg after surgery. I am not aware of any side effects, but that's difficult to gauge because there was no time period when I was not taking it, cannot compare a "before and after" scenario. I do start feeling a bit tired late afternoon, but that can just be the result of a busy day. I am a walker, too, usually 4 miles a day, gym three times a week for the same 3 reasons you noted. I have slowed down somewhat, is it age? I am so glad to read that you are continuing to be as active as you can. Please look at https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/beta-blockers/art-20044522 but remember that even if one person out of 100,000 reports a symptom taking the drug, it's listed as a side effect. We are all different and we are all walking chemical labs with different outcomes when something new is added to the mix. Do ask your doctor if your decreased tolerance for exertion is due to the progression of HOCM or the medication or both.

@walkinggirl and t@thehelloyousay - my cardiologist and I have discussed all of the above. Yes, the HOCM has progressed somewhat and so has the breathlessness - although I can deal with the breathlessness as it is - not too much reduction in my quality of life from that as of now. I don't have any other symptoms. My understanding is that any of the meds for HOCM are basically just treating symptoms so that we sustain quality of life. I'm not sure if the beta blocker would decrease my quality of life more than it would improve it. I have had significant depression episodes all of my life but have now been staple and happy for 3+ years. Anything that could lead to that is off the table for me. It seems like beta blockers often lead to fatigue and depression. I'm wondering what people have experienced on beta blockers, particularly with depression??? P.S. - I love your comment that "we are all walking chemical labs!"

@joycehocm I looked for reliable online studies regarding beta blockers and depression. I found https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.120.16590, in the summary "Various psychiatric adverse events occurred relatively frequently during β-blocker therapy, with depression being the most common. However, compared with placebo, β-blocker therapy was not adversely associated with depression and most other psychiatric adverse events." Next time you pick up a prescription, you may ask the pharmacist the latest about what is known about beta blockers and depression drugs. The same question should be asked of your medical care team. Your work in stabilizing depression is successful ((HUGS)) and of course, one never wants to do anything to destabilize it. Yes, the drugs treat the symptoms, having surgery eliminates the physical presence of ventricle thickening. For some of us, a critical moment arrived and what we were able to deal with is worse and needed stronger intervention. You may wish to discuss possible future options with your care team.

@walkinggirl - wow! thank you for the info on the studies - this is hugely helpful. My COE cardiologist thought I should try low dose beta blocker and "see" what side effects I might have - I am ambivalent but thinking more positively about trying since our exchange - thank you. Future options are pretty scarey but I guess things can reach that point. Last question - can you tell me what EF and gradient would indicate the need for more invasive procedures? If there is such a standard? I'm trying to figure out how "close" I am to the possibility of surgery. Thank you so much!

@joycehocm I am glad you found useful information in the posts. As you know, we are all different. I was doing OK till 2/2022, don't know what my EF was. My cardiologist had been trying to get me to have surgery for a few years, Camzyos was still in the testing stage. I suspect that the crucial EF is different for everyone as to when a next step is needed, do ask your doctor!

@joycehocm I was on Metoprolol 25 mg succinate for a year and then the cardiologist increased to 50 mg succinate because of my short of breath and fatigue symptoms. I was then referred to a COE for HOCM and was told the beta blocker Metoprolol was just treating the symptoms and my condition was in the severe stage and get worse quickly. I was prescribed Camzyos 5 mg in May 2025. I stayed on the beta blocker until Sept 2025. I did have some increase in blood pressure after stopping the beta blocker but by taking blood pressure daily, I consulted with my HOCM team and they put me on Valsartan 160 mg for a few weeks and then increased to 320 mg and problem is pretty much resolved. My heart rate has increased some since going off the beta blocker Metoprolol but I feel so much better, definitely less fatique. I am getting back to where I can go cycling often with less fatigue and had to stop running for almost a year and for the last couple months I have been able to cautiously resume running but getting better every week. I have had great results from the Camzyos and it has been a life changer for me. FYI I am 64 years old and will be 65 soon and have been active most of my life and it has not only helped me physically but I am better mentally since I feel better and can do more normal things.

@thehellyousay I just started 2 days ago on Camzyos, 5mg. They only have had me on 12.5mg of Metoprolol. I don't think I could handle taking 50, but guess we are all so different. Wish you the best of luck. I pray my journey goes well. It's all so new.