Can Someone with Heart Disease Exercise, and Which Exercises Are Safe?

In the past, people with heart disease were advised to rest for long periods, but today scientific research shows that this is not always right. On the contrary, regular exercise as recommended by a doctor is an important part of treatment for many people with heart disease. Today we know that appropriate exercise:

• Helps the heart work more efficiently.
• Can lower blood pressure.
• Can improve cholesterol levels.
• Can help control blood sugar.
• Can make weight loss easier.
• Can reduce the risk of heart attack and hospitalization.
• Can improve quality of life.

However, not every person with heart disease can do the same exercise. An exercise program should be planned according to the type and severity of the person's heart disease and their overall health.

Can People with Heart Disease Exercise?

Yes. Most people with heart disease can exercise safely following their doctor's recommendations. Regular physical activity is an important part of treatment in many conditions, such as:

• Coronary artery disease
• Heart failure
• Hypertension
• Certain stages of heart valve disease
• The period after a heart attack
• After stenting or bypass surgery.

How Does Exercise Benefit the Heart?

Regular exercise:

• Can increase the heart's pumping capacity.
• Can lower the resting heart rate.
• Can help blood vessels work more healthily.

Can slow the progression of atherosclerosis (hardening of the arteries). Can reduce insulin resistance. Can reduce inflammatory processes. Can have a positive effect on mental health. All of these help reduce the risk of cardiovascular disease. • • • •

Which Exercises Are the Safest?

For most people with heart disease, moderate-intensity aerobic exercises are the safest and most commonly recommended activities. Examples:

• Brisk walking
• Cycling on flat ground
• Swimming (if your doctor approves)
• Light jogging (in suitable patients)
• Elliptical trainer
• Low-impact aerobic exercises
• Dancing
• Light hiking

These exercises increase the heart's endurance while putting less strain on the joints.

How Much Exercise Should Be Done per Week?

According to international guidelines, the recommendation for most adults is:

• At least 150 minutes of moderate-intensity aerobic exercise per week
• or
• 75 minutes of vigorous-intensity exercise per week.

For people with heart disease, however, the duration and intensity of exercise should be tailored to the individual. For beginners:

• You can start with 10–15 minutes a day.
• The duration can be increased gradually over time.

What Does Moderate-Intensity Exercise Mean?

During exercise:

• Your breathing speeds up.
• You sweat lightly.
• You can talk but would have difficulty singing.

This level is considered suitable for most people with heart disease.

Can Weight (Resistance) Training Be Done?

Yes. Light or moderate resistance exercises may also be recommended for suitable patients. For example:

• Light dumbbells
• Resistance bands
• Bodyweight exercises
• However, lifting very heavy weights or strength exercises done while holding your breath may be

harmful for some people with heart disease.

When Can Someone Who Has Had a Heart Attack Start Exercising?

For people who have had a heart attack, when to start exercising depends on:

• The degree of damage to the heart,
• The type of treatment,
• The patient's overall condition.

For most patients, after evaluation by a doctor, supervised exercise is recommended as part of a cardiac rehabilitation program.

Can You Exercise After Stenting or Bypass Surgery?

Yes. After successful treatment, many people can return to an active life. However:

• The timing,
• Duration,
• And intensity of exercise should be determined by the doctor.

Cardiac rehabilitation programs are very beneficial during this period.

Can Patients with Heart Failure Exercise?

In the past, this was thought to be harmful. Today, however, in appropriately selected patients with heart failure, regular exercise has been shown to:

• Reduce shortness of breath,
• Increase exercise capacity,
• Reduce hospitalizations,
• Improve quality of life.

When Should You Not Exercise?

In the following situations, exercise should be postponed and you should see a doctor:

• Chest pain at rest
• Uncontrolled high blood pressure
• Severe shortness of breath
• Illness with fever
• A newly developed rhythm disorder
• Fainting
• Signs of advanced heart failure

Which Symptoms Should Make You Stop During Exercise?

, If the following symptoms develop during exercise, the activity should be stopped immediately:

• Chest pain or a feeling of pressure
• Severe shortness of breath
• Dizziness
• Feeling faint
• Cold sweats
• Sudden onset of palpitations
• Severe weakness

If these symptoms continue, emergency medical evaluation is needed.

What Should You Pay Attention to While Exercising?

• • • • • • •

Start exercise with warm-up movements. Do not stop exercising abruptly; do cool-down movements. Be careful in very hot or very cold weather. Stay hydrated. Wear comfortable clothing and suitable athletic shoes. Take the medications your doctor recommends regularly. Increase exercise intensity gradually.

If I have heart disease, can I go for walks?

Yes. Brisk walking is one of the safest and most beneficial exercises for most people with heart disease. However, its duration and pace should be determined according to your doctor's recommendation. Is it harmful to raise my heart rate too much? For some people with heart disease, target heart rate ranges may be set. For this reason, people with heart disease in particular should adjust their exercise intensity according to their doctor's recommendations. Can people with heart disease lift weights? Light and controlled resistance exercises are suitable for many patients. However, lifting heavy weights may not be safe for every patient. Does exercise replace medications? No. Exercise is an important part of treatment, but it does not replace the medications your doctor recommends.

Conclusion:

• Most people with heart disease benefit significantly from properly planned regular
• exercise. Moderate-intensity physical activities such as brisk walking, cycling, swimming, and light
• resistance exercises can support heart health,
• improve quality of life, and reduce the risk of heart attack and hospitalization. However,
• the exercise program should be individualized and planned by taking into account the type of disease, the type of treatment, and overall
• health. Especially after a heart attack, stenting, bypass surgery, or heart
• failure, cardiac rehabilitation programs are one of the most effective ways

to develop safe exercise habits.

References:

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Pelliccia A, et al. ESC Scientific Document Group. 2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease. Eur Heart J. 2021 Jan 1;42(1):17-96. Anderson L, et al. Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database Syst Rev. 2016 Jan 5;2016(1):CD001800. Garber CE, et al. American College of Sports Medicine. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults:

guidance for prescribing exercise. Med Sci Sports Exerc. 2011 Jul;43(7):1334-59. Virani SS, et al. 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Circulation. 2023 Aug 29;148(9):e9-e119. Piepoli MF, Davos C, Francis DP, Coats AJ; ExTraMATCH Collaborative. Exercise training meta-analysis of trials in patients with chronic heart failure (ExTraMATCH). BMJ. 2004 Jan 24;328(7433):189.

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