Exercising safely and effectively with cardiovascular disease

Woman performing a single-leg balance assessment on a VALD platform.

Dr Brea Kunstler (Physiotherapist and Run Coach)

Regular physical activity can help prevent cardiovascular disease (CVD) and support people living with the condition. A healthy lifestyle combines regular exercise, less time spent sitting, avoiding smoking and maintaining a balanced diet. These habits can also help maintain a healthy body mass index (BMI). This article explores practical ways to reduce sedentary time and explains how physical activity can lower the risk of future cardiovascular events.

How much physical activity helps prevent CVD?

For adults, the physical activity guidelines recommend at least 150 minutes of moderate-intensity activity, such as brisk walking, or 75 minutes of vigorous-intensity activity, such as running, each week. However, some physical activity is better than none. If you cannot meet these targets, doing what you can is still worthwhile.

It is also important to break up long periods of sitting or lying down. Although the best approach can vary, a practical starting point is to get up and move at least once every hour.

Starting physical activity when you have CVD

People with CVD may feel worried that physical activity could make their condition worse. Physical activity is generally encouraged for people with CVD and related risk factors. However, assess individual risk before starting or increasing exercise, particularly high-intensity activity.

The right exercise plan depends on a person’s health and capabilities. For example, someone who has recently had a cardiovascular event, such as a heart attack, may be considered at higher risk than someone with hypertension (high blood pressure). A medical risk assessment by the person’s treating clinician is therefore important before an exercise programme begins.

Exercise for people with CVD risk factors

People with risk factors such as obesity, hypertension, dyslipidaemia (abnormal levels of lipids in the blood) and type 2 diabetes are encouraged to be physically active. Activity can help manage these risk factors and reduce the risk of CVD. In many cases, the general activity guidelines are a useful starting point, although some people may need adjustments.

People with obesity (BMI above 30) and/or hypertension (blood pressure above 140/90) may benefit from adding three strength-training sessions each week. For people with type 2 diabetes, regular activity can also help manage blood glucose levels.

Rather than focusing only on the weekly activity target, people with type 2 diabetes may benefit from moving regularly throughout the day. This can include daily moderate-intensity activity, strength exercises and breaking up sedentary time with light movement every 30 minutes, such as standing or walking briefly.

Exercise options for people with stable CVD

Many people with CVD who are clinically stable and have medical clearance take part in cardiac rehabilitation or increase their activity at home or in the community. These approaches aim to help prevent further cardiovascular events, such as a stroke following a heart attack. Programmes often combine aerobic activity with strength training. Combining both types of exercise can offer benefits for secondary prevention compared with aerobic activity alone, such as walking.

Exercise guidance for coronary artery disease

People with coronary artery disease need exercise recommendations that take account of the type, intensity and duration of activity that is appropriate for them. These exercise recommendations may differ from those for people without coronary artery disease.

Exercise programmes often start with moderate-intensity aerobic activity. Strength training may follow. The programme should progress according to the person’s fitness and health. Vigorous activity may offer additional benefits. However, it must remain within safe limits and follow clinical guidance.

Get advice before starting an exercise programme

Guidance for other types of CVD can be found here. If you have a history of CVD and want to begin an exercise programme, speak with your cardiologist about which activities are appropriate for you. You may also be able to ask for a referral to an exercise specialist.

Need some help achieving your running goals? Book a telehealth appointment with Performance Medicine’s exercise and run coach, Dr Brea Kunstler, to see how she can help you achieve your goals. She can provide a referral to a trusted shoe provider who will give you 10% off the RRP of your new shoes.

Dr Brea Kunstler