Exercise for people with heart disease.

There is good evidence that regular exercise helps to prevent and treat cardiovascular disease. Physical inactivity almost doubles the risk of acquiring heart disease.

The National Heart Foundation recommends that people with clinically stable heart disease should aim, over time, to achieve 30 minutes of moderate exercise on most days of the week.

Low intensity physical activity, elicits a slight increase in breathing rate and is relative for a given person (eg, strolling < 3 km/h on level firm ground, tidying the house, leisurely stationary cycling < 50 watts, and social lawn bowls).

Moderate intensity physical activity, elicits a moderate, noticeable increase in depth and rate of breathing, while still allowing comfortable talking and is relative for a given person (eg, purposeful walking 3–6 km/h on level firm ground, water aerobics, cycling for pleasure < 16 km/h, and cleaning the house).

The benefits of exercise can include increased physical function, reduction in symptoms, enhanced quality of life, reduction in the risk of coronary events, a decreased risk of death, improved muscle fitness. These benefits may decrease on discontinuation of exercise. The risks of a major cardiac event or death are low in patients who are properly evaluated and supervised (1 in 117,000 to 1 in 750,000 hours of exercise).

Before starting an exercise regime, you should have a thorough review and physical exam by your doctor. You may require a stress test supervised by your cardiologist. You may benefit from supervised exercise in a formal exercise program. You should not undertake an exercise program if you suffer from unstable angina, severe heart valve disease, uncontrolled high blood pressure, severely low blood pressure, acute infection, abnormal heart rhythm, or unstable diabetes.

Patients who have had a myocardial infarction, an episode of unstable angina, a bypass operation or a stent insertion, benefit from undergoing a formal cardiac rehabilitation program.