DEAR DR. GOTT: I’m a 54-year-old female who had a heart attack at age 47. They think it was a coronary spasm.

I’ve begun to work out recently with a personal trainer because I am about 80 pounds overweight. He is concerned that I have difficulty getting my heart rate up. After 20 to 30 minutes of cardio (3 miles per hour at a 2 percent incline on the treadmill), my heart rate is still around 98 to 105. Should I be working harder or could it be a result of taking Toprol XL even though I do not have high blood pressure, nor have I ever had it? My cardiologist thinks taking 1/2 of a 100-milligram tablet daily is a good idea to prevent future attacks.

I also take simvastatin, tizanidine and an 81-milligram aspirin each day. My triglyceride result just came back at 223, but the rest of my cholesterol was normal. My total was 180, and my heart rate while standing still is about 68. And I smoke cigars daily. Need I worry? My trainer is.
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