Working It! How Exercise Helps Fight Heart Failure

Used to be that heart-failure patients were told to rest, rest, rest. Now experts say physical activity is vital—here’s what you need to know to get started.

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After a heart-failure (HF) diagnosis, you may be scared to be physically active—after all, your heart isn’t pumping as well as it should be. And for a long time, people with this condition were told to take it easy and rest. But according to the Heart Failure Society of America (HSFA), more recent research shows that it’s perfectly safe and even healthy to exercise. In fact, experts recommend it.

That's because the benefits are particularly powerful for people with heart failure. Physical activity not only helps you maintain (or achieve) a healthy level of fitness, the evidence shows it improves quality of life and, in certain patients, even increases survival, says Gurusher S. Panjrath, M.D., associate professor of medicine at George Washington University and chair of the American College of Cardiology Heart Failure and Transplantation Council. It may even improve your heart’s function, according to the HFSA.

What does all this add up to? A much fuller and vibrant life. You’ll be likely be able to continue working, enjoying sex, seeing friends, and simply doing the things you love. Pretty worth it.

So How Much Exercise Should You Get?

People with heart failure typically should aim to work up to about 30 minutes of physical activity most days of the week, according to the HFSA. Remember: You don’t have to do all 30 minutes in a row. You can also split it into chunks, like three 10-minute walks throughout the day.

But everyone is different—this may not be the ideal level of exercise for some people with heart failure. Always, always, always talk to your doctor before jumping into any new fitness routine. Got it? Always.

You’ll want to ask your cardiologist about your ideal activity level and the maximum heart rate you should reach, advises Dr. Panjrath. “The key thing is to be aware about your body’s limits.”

Your doctor may recommend you monitor your pulse when you exercise or take your meds at a certain time of day if you plan to work out that day.

Activities That Help Your Heart

Focus most of your time on aerobic exercise rather than say, weight lifting, because aerobic exercise is what’s going to bring you the most heart health benefits, says Dr. Panjrath. Pick a low-impact aerobic activity you enjoy, even if that’s just brisk walking around your neighborhood (more on this below). Biking on flat roads, swimming, gardening, using the elliptical, or even bowling are good options too.

Whatever you’re doing, you’ll want to start slow, build gradually, and make sure you can carry on a conversation—if talking to someone becomes difficult, that’s a sign your activity may be getting too vigorous and you need to roll it back. As you get stronger, you may want to increase your activity level. But again, check in with your M.D. before you ramp it up. Your doctor may want to do an exercise test with you beforehand, such as monitoring you while you’re on the treadmill.

Why Walking May Be the Best Choice for Heart Failure Patients

Brisk walking is an excellent choice for people with heart failure who are looking to get active. It not only improves muscle tone and endurance, according to the Cleveland Clinic, but it’s also easy to start and maintain: That’s because you can control your own pace, it’s free, and it requires no special equipment. Just make sure you get walking shoes that fit well and provide support.

You can walk outside if the weather is nice, or if it’s too hot or too cold (below 20 degrees or above 80°F with more than 80% humidity), you can head to your local gym or even an indoor mall to get your steps in. Another plus of walking? You can easily do it with a friend or loved one, taking the time to catch up or even have a phone call.

Don’t push yourself to maintain your top pace when going up hills—you don’t want to get too tired. It helps to plan your walks ahead of time so you know exactly where you’re going and when it’s time to loop back, says the Cleveland Clinic.

Warming Up and Cooling Down

These are key parts of any exercise session, but they’re especially key for people with heart failure because they can help you avoid injury and keep you from stressing out your heart, says the HFSA.

Spend about 5 minutes warming up before you start your exercise activity, like walking slowly. Warming up helps you literally warm up your body and gets your heart used to the activity gradually.

When it comes time to cool down, slowly decrease the intensity of your exercise—don’t just suddenly stop mid-exercise. You want to make the end of your workout gradual, otherwise you can get dizzy or lightheaded, says the HFSA. Taking the time to cool down will help your heart rate and blood pressure return to their normal rates slowly. You can also incorporate a few minutes of stretching into your cooldown.

When to Consider a Cardiac Rehabilitation Program

When you’re diagnosed with heart failure, your doctor may recommend you take part in a cardiac rehabilitation (rehab) program, says Dr. Panjrath. These programs are supervised by health care providers and involve education, exercise training, and more counseling on heart-healthy living to help you move forward after heart failure diagnosis, according to the American Heart Association (AHA).

Typically, a physical and occupational therapist, along with the rest of your rehab team, will help you learn how to exercise in a way that will help manage your heart failure, according to the AHA. That way, you’ll learn from the get-go how to stay active in the healthiest way for you and your heart. Talk to your doctor about whether a rehab program is a good fit for you.

When to Avoid Exercise

It’s important to keep a close eye on how you feel with heart failure. Sometimes, it’s simply not a good idea to work out. Here are signs you should skip your daily activity, according to the HFSA:

  • You feel exhausted.
  • You’re short of breath even at rest, or you’re experiencing more HF symptoms than usual.
  • You have chest pain.
  • You have a fever, infection, or other symptoms of illness.
  • You are in the middle of a big medication change.
  • You have persistent aches or pains in the parts of your body or muscles you are exercising.

If you have concerns about what you’re feeling, it’s best to contact your doctor and check in about what type of activity is safe for you.

Warning Signs to Watch For

You also need to closely monitor how you’re feeling when you’re actually exercising. Overexerting yourself when you have heart failure can be dangerous. If you have any of these symptoms during physical activity, slow down:

  • Shortness of breath
  • Extreme weakness
  • Dizziness or lightheadedness
  • A fast or irregular pulse (if it’s still over 120 to 150 beats per minute after 15 minutes of resting with your feet up, call your doctor)
  • Chest pain or tightness, or pain in your arms, shoulders, jaw, or neck

If your symptoms don’t get better when you slow down, stop your activity. You should call 911 right away if you have chest pain or pressure in your chest, arm, shoulders, jaw, or neck, the Cleveland Clinic says.

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When It Comes to Reducing Heart Failure Risk, ‘More Exercise is Better’