Heart and lung conditions

Is it safe to exercise with a heart condition?

For most people with a heart condition, yes: being active is generally helpful rather than dangerous. Getting your heart and lungs working a bit harder tends to improve your health and reduce the strain on your heart¹. Exercise is safe for most people, and its cardiovascular risks lessen as you become more active and fit⁴. Problems during exercise are often preceded by warning signs, so pay attention to how you feel⁴.

The general principle is to "start low and go slow": begin with activities you can manage easily, then gradually build up how much effort you put in over weeks¹.

After a heart attack, stroke or new diagnosis of heart failure, it is best to increase your activity within a supervised rehabilitation programme. That is true even if you were very active before¹. Staying active is an important part of looking after your heart after a heart attack, so speak to your doctor, nurse or cardiac rehabilitation team before you start again⁵. If you have recently been diagnosed with a heart condition, or you are starting something new or more strenuous, talk to your healthcare team first¹.

Chest pain, pressure or tightness during or after activity is an emergency: stop and call the emergency number straight away, without waiting to see if it passes, even if you're not sure. The exception is someone with diagnosed angina who is following the action plan their doctor gave them.

What is cardiac rehabilitation?

Cardiac rehabilitation is a programme that helps you recover and get back to living your life after a heart attack or with heart failure². Supervised exercise training is at its centre. Most programmes also include talks on managing your condition and taking medicines, relaxation and stress management, and support for anxiety and low mood. The team tailors the programme to your age, fitness level and any other medical issues². The American Heart Association lists the core parts as assessment, nutrition advice, weight management, risk factor management, psychological support, aerobic exercise, strength training and physical activity counselling⁶.

What it can do for you:

• Coronary heart disease: exercise-based rehabilitation likely reduces heart attacks over the following 6 to 12 months⁷.
• Heart failure: it reduces hospital admissions, with little or no difference to short-term death rates^8,9.
• Quality of life: it may improve in heart failure, although how much is less certain^8,9.

Eligible people with heart disease, especially coronary heart disease and heart failure, should be routinely referred to a formal programme¹⁰. If you've had a heart attack or have heart failure, ask your doctor, nurse or hospital team whether you're eligible.

How can people with COPD stay active?

The strongest support is for pulmonary rehabilitation: a programme of exercise training lasting at least four weeks, which may also include education and support. In adults with COPD it improves quality of life and walking distance³. It is recognised as a core part of managing chronic lung disease¹¹, and it is described as reducing breathlessness and hospital admissions¹².

To find out more, ask your doctor or a respiratory health professional for a referral¹³. Places can be hard to get¹⁴. Common barriers are travel and transport, poor timing of sessions, competing demands on your time, cost and illness¹². If you can't get to a programme, ask about other options, such as exercise referral schemes at your doctor's surgery.

Outside a formal programme, a step goal and keeping track of your steps can help: in people with COPD, both were linked with several hundred more steps a day¹⁵.

• Pick a starting number of daily steps you can reach most days.
• Write down or count your steps so you can see progress.
• Review the goal now and then, and raise it a little when it feels easy.

When to check with a health professional

If you're starting exercise after a long break, it's always a good idea to see your doctor first. For an injury or a health condition, see a health professional, such as your doctor or a physio. If your heart or lung condition is unstable or poorly controlled, ask your doctor or rehabilitation team about a plan made for you³.

Exercise doesn't replace prescribed medicines or treatment. Keep taking them as prescribed, and talk to your doctor before changing or stopping them.

Call your local emergency number for chest pain or pressure (or pain spreading to the arm, neck, jaw or back, especially with sweating or feeling sick), severe breathlessness, fainting or collapse, signs of a stroke, a serious injury, or someone who isn't safe.

For a sore muscle or joint, soreness a day or two later, or a flare of your condition, ease off. See a doctor if it persists or gets worse. If you have unexplained discomfort, or feel dizzy, sick or sweaty, stop and rest: if it doesn't settle, call your local emergency number; if it has settled, see a doctor soon. If you feel unusually tired, get it checked by a doctor. A heart or lung health organisation in your country can also offer support.