Getting regular exercise when you have heart disease is important.

Exercise can make your heart muscle stronger. It may also help you be more active without chest pain or other symptoms.

Exercise may help lower your blood pressure and cholesterol. If you have diabetes, it can help you control your blood sugar.

Regular exercise can help you lose weight. You will also feel better.

Exercise will also help keep your bones strong.

Always talk with your health care provider before starting an exercise program. You need to make sure the exercise you would like to do is safe for you. This is particularly important if:

• You recently had a heart attack.
• You have been having chest pain or pressure, or shortness of breath.
• You have diabetes.
• You recently had a heart procedure or heart surgery.

Your provider will tell you what exercise is best for you. Talk with your provider before you start a new exercise program. Also ask if it is OK before you do a harder activity.

Aerobic activity uses your heart and lungs for a long period of time. It also helps your heart use oxygen better and improves blood flow. You want to make your heart work a little harder every time, but not too hard.

Start slowly. Choose an aerobic activity such as walking, swimming, light jogging, or biking. Do this at least 3 to 4 times a week.

Always do 5 minutes of stretching or moving around to warm up your muscles and heart before exercising. Allow time to cool down after you exercise. Do the same activity but at a slower pace.

Take rest periods before you get too tired. If you feel tired or have any heart symptoms, stop. Wear comfortable clothing for the exercise you are doing.

During hot weather, exercise in the morning or evening. Be careful not to wear too many layers of clothes. You can also go to an indoor shopping mall to walk.

When it is cold, cover your nose and mouth when exercising outside. Go to an indoor shopping mall if it is too cold or snowy to exercise outside. Ask your provider if it is OK for you to exercise when it is below freezing.

Resistance weight training may improve your strength and help your muscles work together better. This can make it easier to do daily activities. These exercises are good for you. But keep in mind they do not help your heart like aerobic exercise does.

Check out your weight-training routine with your provider first. Go easy, and do not strain too hard. It is better to do lighter sets of exercise when you have heart disease than to work out too hard.

You may need advice from a physical therapist or trainer. They can show you how to do exercises the right way. Make sure you breathe steadily and switch between upper and lower body work. Rest often.

You may be eligible for a formal cardiac rehabilitation program. Ask your provider if you can have a referral.

If exercise puts too much strain on your heart, you may have pain and other symptoms, such as:

• Dizziness or lightheadedness
• Chest pain
• Irregular heartbeat or pulse
• Shortness of breath
• Nausea

It is important that you pay attention to these warning signs. Stop what you are doing. Rest.

Know how to treat your heart symptoms if they happen.

Always carry some nitroglycerin pills with you if your provider has prescribed them.

If you have symptoms, write down what you were doing and the time of day. Share this with your provider. If these symptoms are very bad or do not go away when you stop the activity, let your provider know right away. Your provider can give you advice about exercise at your regular medical appointments.

Know your resting pulse rate. Also know a safe exercising pulse rate. Try taking your pulse during exercise. This way, you can see if your heart is beating at a safe exercise rate. If it is too high, slow down. Then, take it again after exercise to see if it comes back to normal within about 10 minutes.

You can take your pulse in the wrist area below the base of your thumb. Use your index and third fingers of the opposite hand to locate your pulse and count the number of beats per minute.

Drink plenty of water. Take frequent breaks during exercise or other strenuous activities.

Contact your provider if you feel:

• Pain, pressure, tightness, or heaviness in the chest, arm, neck, or jaw
• Shortness of breath
• Gas pains or indigestion
• Numbness in your arms
• Sweaty, or if you lose color
• Lightheaded

Changes in your angina may mean your heart disease is getting worse. Contact your provider if your angina:

• Becomes stronger
• Occurs more often
• Lasts longer
• Occurs when you are not active or when you are resting
• Does not get better when you take your medicine

Also contact if you cannot exercise as much as you are used to being able to.

Heart disease - activity; CAD - activity; Coronary artery disease - activity; Angina - activity

Fihn SD, Blankenship JC, Alexander KP, et al. 2014 ACC/AHA/AATS/PCNA/SCAI/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines, and the American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2014;130:1749-1767. PMID: 25070666 pubmed.ncbi.nlm.nih.gov/25070666/.

Mora S, Libby P, Ridker PM. Primary prevention of cardiovascular disease. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 25.

Morrow DA, de Lemos J. Stable ischemic heart disease. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 40.

Thomas RJ. Comprehensive cardiac rehabilitation. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022 chap 33.

Updated by: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.