Heart Failure Health Center

When you have heart failure, it's very important to exercise regularly. If you are not already active, your doctor may want you to start an exercise program.

Of course, what's safe for you depends on how bad your heart failure is. But even if you can only do a small amount of exercise, it's better than not doing any exercise at all.

Key points

• Have a checkup before you start an exercise program. Your doctor probably will do an electrocardiogram (EKG or ECG) and maybe an exercise stress test to see how much activity your heart can safely handle.
• Your doctor may recommend a cardiac rehabilitation ("rehab") program at a local hospital or clinic. For more information, see the topic Cardiac Rehabilitation.
• Start out slowly, exercising for only a few minutes at a comfortable rate. Then each day, slowly try to increase the length of time and the intensity of your workout.
• You should not exercise during times when your heart failure is not under control.
• Set goals that you can reach. If you expect too much, you are likely to get discouraged and stop exercising.

Do not start exercising until you have talked with your doctor to make an exercise program that is safe for you. Your program will likely include activities that you can do at least 3 to 5 times a week. Aim for at least 2½ hours of moderate exercise a week. One way to do this is to be active at least 10 minutes 3 times a day, 5 days a week.

• Stretching for 10 to 15 minutes helps warm up muscles. Basic yoga or tai chi exercises might help you be more flexible.
• You also may be able to walk outdoors or on a treadmill, cycle on a stationary bike, do low- or no-impact aerobics, or swim. All of these make your muscles stronger, help you keep your balance, and make you more fit.
• Lifting light weights helps increase the tone and strength of your muscles.
• It's a good idea to have a cool-down period. This means slowly stopping your exercise, such as walking at a slower pace for 5 to 10 minutes.

Making exercise a routine is important, because it takes only a short period without activity to weaken your muscles and your heart.

Regular exercise also helps reduce:

• Chest pain (angina) and symptoms of heart failure.
• Cholesterol , especially when combined with lifestyle changes, such as eating a heart-healthy diet and not smoking.
• Blood pressure. Regular exercise can lower your blood pressure. It helps even more when it's combined with other lifestyle changes, such as eating a healthy diet and learning to handle stress.
• Your weight. And it can help you stay at a healthy weight when you reach it.
• Blood sugar levels, which can lower your risk for diabetes and help you manage your diabetes.
• Stress. It also helps lift your mood and decreases depression and anxiety.

To get started:

• Have a physical exam before you start any exercise program. Your doctor may do an electrocardiogram (EKG or ECG) and maybe an exercise stress test.
• Make a list of questions to discuss with your doctor. Make your list before your appointment. For some general questions, see the exercise planning sheet(What is a PDF document?).
• Make an exercise plan with your doctor. An exercise program usually consists of stretching, activities that increase your heart rate, and strength training. Visit a library or bookstore for information on exercise programs. Join a health club, walking group, or YMCA. Many cities have senior centers that offer exercise programs that don't cost much. See the Other Places to Get Help section of the topic Heart Failure for more resources.
• Learn how to check your heart rate. See taking a pulse . Your doctor can tell you how fast your pulse (target heart rate) should be when you exercise.
• Start out slowly. Try parking farther away from the store, or walk the mall before you shop. Over time, you will increase your ability to do more.
• Keep a record of what you do. Now and then, read entries from months ago to see your progress. It's okay to cut back on your exercise if you are too tired or not feeling well.

Tips for exercise success

• Set realistic goals. If you expect too much, you are likely to get discouraged and stop exercising.
• Choose a type of exercise that you enjoy.
• Give yourself time. It can take months to get into the habit of exercising. After a few months, you may find that you are looking forward to it.
• Stay with it. It can be hard to stay with an exercise plan. Try exercising with a friend. It is much easier to continue an exercise program if you are doing it with someone else.
• Reward yourself. Build in rewards along the way that help you stay with your program.

When starting an exercise program, keep the following in mind:

• Pace yourself by switching exercises. Rotate light workouts, such as short walks, with more intense exercises, such as low-impact aerobics or swimming.
• Avoid exercising outdoors in extreme weather or high humidity. When the weather is bad, try exercising indoors at a gym or walking at a mall.
• If you get palpitations, chest pain, trouble breathing, or dizziness or lightheadedness, stop exercising and try to rest. Call 911 if your chest pain does not go away. Call your doctor if your other symptoms don't go away.
• Don't take naps or lie down after exercise, because that reduces your ability to exercise. Instead, sit down to rest.
• Take your pulse often or wear a heart rate monitor, and keep your pulse within the range your doctor sets. Watch your pulse when walking up hills or stairs.
• Be aware of how you feel during exercise. You should be able to talk easily without being out of breath.

Other things to think about

• Avoid exercises that require or encourage holding your breath, such as push-ups, sit-ups, and isometric exercises. Also avoid heavy lifting.
• Do not take hot or cold showers or sauna baths after you exercise. Medium temperatures are best-very hot or very cold temperatures can be dangerous.
• Ask your doctor if you need to change how you exercise if your medicines change. New medicines can affect how fast your heart beats and how you feel when you exercise.
• Get back to exercise slowly if you've stopped your workouts for more than just a couple of days. Slowly increase to your regular activity level as you are able to.

Now that you have read this information, you are ready to plan the exercise program that suits you.

Talk with your doctor

If you have questions about this information, print it out and take it with you when you visit your doctor. You may want to use a highlighter to mark areas or make notes in the margins of pages where you have questions.

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