Increase in sedentary lifestyles makes promoting physical activity more important than ever  

Physical activity is recommended for everyone with heart disease and can actually reduce the risk of someone with heart disease dying early, according to new international guidelines.

The first-ever recommendations on sports and physical activity for people with heart disease were launched recently by the European Society of Cardiology (ESC) and according to the report, just like healthy adults of all ages, people with heart disease should exercise on most days, totaling at least 150 minutes per week of moderate-intensity exercise. Moderate intensity means increasing your heart rate and breathing rate but still being able to hold a conversation.

“With rising levels of obesity and sedentary lifestyles, promoting physical activity is more crucial now than ever before,” said Professor Antonio Pelliccia, Chairperson of the guidelines Task Force and chief of cardiology, Institute of Sports Medicine and Science, Rome, Italy.

“Regular exercise not only prevents heart disease but also reduces premature death in people with established heart disease.”

“The chance of exercise triggering a cardiac arrest or heart attack is extremely low,” said Professor Sanjay Sharma, Chairperson of the guidelines Task Force and professor of sports cardiology and inherited cardiac diseases, at St. George’s, University of London, UK. “People who are completely inactive and those with advanced heart disease should consult their doctor before taking up sports.”

The document covers leisure exercise and competitive sports for people with heart disease and conditions, which raise the risk of heart disease such as obesity and diabetes.

Advice is also given on exercise during pregnancy, or in special settings such as at high altitude, in deep-sea, in polluted areas, and at extreme temperatures. The document states that traffic fumes are unlikely to lessen the benefits of physical activity to heart health.

For people living with obesity or those with high blood pressure or diabetes, the guidelines recommend strength-building exercise (for example, lifting light weights) at least three times a week plus moderate or vigorous aerobic exercise, such as cycling, running, or swimming.

Coronary artery disease is the most common type of heart disease and is caused by build-up of fatty deposits on the inner walls of the arteries. If the arteries become completely blocked this can cause a heart attack. Most people with coronary artery disease can play competitive or amateur sports.

“People with long-standing coronary artery disease who wish to take up exercise for the first time should see their doctor first,” said Professor Pelliccia. “The aim is to tailor the intensity of activity according to the individual risk of causing an acute event such as a heart attack.”

Regular, moderate physical activity is recommended to prevent the most common heart rhythm disorder – called atrial fibrillation. People with atrial fibrillation who are taking anticoagulants to prevent stroke should avoid contact sports due to the risks of bleeding.

People with pacemakers should not be discouraged from playing sports (except collision sports) because of the device. However, they need to tailor their choice according to the underlying disease.

Professor Pelliccia noted that anyone experiencing chest pain for more than 15 minutes should call an ambulance. He added: “If you find that exercise brings on palpitations or unusual shortness of breath or chest discomfort, scale back your activity and make an appointment to see your health professional.”

Professor Sharma said: “Physical activity is good for everyone with heart disease and even small amounts are beneficial. We hope these guidelines will help patients and their health professionals choose the best and most enjoyable activities for them.”

Dr Angie Brown Medical Director of the Irish Heart Foundation welcomed the new ESC recommendations and said they provided reassurance for patients with cardiovascular disease.

“With rising levels of obesity and sedentary lifestyles – exacerbated with the COVID pandemic, promoting physical activity is more crucial now than ever before. Regular exercise not only prevents heart disease but also reduces premature death in people with established heart disease. This is one reason we have launched our Escape Your Chair campaign to highlight the importance of reducing sitting times with frequent daily activities, this is particularly important as we have found sitting times to be significantly increased now so many people are working from home,” Dr Brown said.

Sitting for long periods of time can increase your risk of heart disease and stroke. Therefore it is important that everyone particularly those living with heart disease try to reduce their sitting time.

The Irish Heart Foundation’s new Escape Your Chair campaign, which runs for the month of September and is supported by the HSE, is urging everyone to get up and move for a minute each hour during the day as a way to kick-start their daily exercise.

As part of the campaign the Irish Heart Foundation has developed a range of sources including a new movement idea for each working day of the month. From marching on the spot to heel taps, high knees, and jumping jacks there is no end to the movements you can do in just one minute.

Cardiovascular, muscle strength, balance, and mobility movements are included throughout the plan so you can improve all aspects of your physical fitness. Why not set a reminder and get moving with the Irish Heart Foundation throughout September.

Download the monthly calendar and sign-up to our e-zines with videos, tips, and a weekly plan to keep you motivated.

(A copy of the new ESC Guidelines on sports and physical activity for people with heart disease are available here)