Physical activity is important for everyone, even people living with heart failure. Research has shown that congestive heart failure patients who follow an exercise-based cardiac rehabilitation program are less likely to be hospitalized and report a better quality of life than those who do not.
“Exercise for most heart conditions is very important,” says Ross Brown, MD, an interventional cardiologist with Memorial Hermann in Houston. “It helps strengthen the heart, lowers blood pressure, helps lower stress levels, and can help improve overall mental health. Most patients will be referred to a cardiac rehab program by their doctors, where their heart rate, ECG, blood pressure, and other physical responses can be monitored while you exercise.
“This is a great place to start an exercise program, especially for patients with heart problems,” says Amy Beitel, a physical therapist in Mount Pleasant, South Carolina.
Under the supervision of specialists, you’ll learn what exercises are safe and appropriate with heart failure. “We can then reassure the patient and help build their confidence that these are the things they can do at home safely once they graduate from the program,” Dr. Brown says.
You can also choose to start exercising on your own. But remember that it’s important to speak to your doctor before beginning any form of exercise.
Once you get cleared by a physician, start out slow. “Begin exercising for only a few minutes at a comfortable rate,” Beitel says. “Then each day, slowly try to increase the length of time and the intensity of your workout.”
When increasing the duration or intensity of the workout, experts recommend using the “talk test”: If you are unable to carry out a conversation while exercising, then you’re most likely overdoing it. The ideal target for patients with mild to moderate heart failure is 30 to 45 minutes of exercise five days a week, Brown says.
Getting Started on an Exercise Plan
When it comes to choosing a type of exercise, experts recommend that patients do physical activities they enjoy the most, though sticking to low-impact activities, like walking, bicycling, or swimming, is best.
Beitel advises beginning each exercise with a warm-up, such as marching in place for about five minutes and doing some upper body stretches. At the end of each session, cool down with some more stretching exercises.
“Never stop exercising all of a sudden and then sit or lie down, or stand still. This can make you feel dizzy or lightheaded,” she says. “Walk around slowly before you stop. If you’re having a hard time doing a full 30 minutes, Brown recommends breaking up the time. “Try 5- or 10-minute intervals, spaced with a break in between,” he says.
Sometimes, heart failure patients, especially older adults, might feel dizzy or lightheaded with physical activity. If this happens to you, Brown recommends chair exercises. “It’s important to keep your feet moving, even if you’re sitting down, so just doing some calf pumps or toe raises can actually help you maintain more stable blood pressure to allow you to do more upper body and other exercises.”
Importantly, you should never exercise during times when your heart failure is not under control. If you notice any heart failure symptoms, including excessive shortness of breath, chest discomfort, palpitations that do not go away, or increasing fatigue, stop exercising and notify your doctor right away.
Beitel also offers these seven tips for exercising safely while living with heart failure:
Avoid exercises that require or encourage holding your breath, such as push-ups, sit-ups, planks, and isometric exercises.
Wait at least one hour after eating to exercise.
Avoid actions that need quick bursts of energy.
Exercise when you have the most energy. For most people with heart failure, that is in the morning.
Think about exercising with a friend or family member. It’s easier to stay with it when you have a partner, and it can be an enjoyable social time.
Don’t exercise if you are sick or have a fever.
Avoid exercising outdoors in extreme weather or high humidity.