Exercise With Pulmonary Arterial Hypertension

Medically Reviewed by Neha Pathak, MD on January 02, 2019
4 min read

Everyone knows exercise plays an important role in staying healthy. It plays an even bigger part if you have pulmonary arterial hypertension (PAH).

PAH affects how well blood flows through the vessels in your lungs. It can affect how well the right side of your heart works. Along with medications, a healthy diet, and supplemental oxygen if necessary, exercise may help you:

  • Breathe easier
  • Have more endurance
  • Strengthen your muscles, joints, bones, and heart

That'll make you better able to do the things you enjoy, whether that’s gardening, playing with your kids or grandkids, or taking the dog for a stroll.

The trick is to find things that you enjoy and can do safely.

“There was a time when we used to say that exercise was off-limits to patients with pulmonary hypertension. Now, we know better,” says Robert Schilz, DO, the director of lung transplantation at University Hospitals Cleveland Medical Center.

“Exercise fights an ugly spiral of feeling lousy because of the disease and feeling lousy because you’re not moving.”

Before you start exercising, it's important to talk to your doctor. If there are a lot of activities you can't do, or you get dizzy or faint when you work out, it may not be the best thing for you.

If you're stable, your doctor will recommend a rehabilitation specialist. This person can create a plan around your needs and any limitations that you may have. Most last between 4 and 12 weeks.

Generally, they include tried-and-true forms of exercise that help people with breathing problems. Like any workout program, you may begin by doing light stretches to warm up, followed by walking on a treadmill or even cycling, depending on your health. The exercises you do, and how long you do them, will change as you get stronger.

“Beginning an exercise program can be scary, but [folks] usually wind up loving their rehab programs because they are closely monitored, which makes them feel safe and more in control,” says Rana Awdish, MD, the director of the pulmonary hypertension program and critical care medicine at Henry Ford Health System in Detroit.

The big payoff comes when they start to see improvements. “When people with pulmonary hypertension can see what they can do versus what they can’t do, that’s a huge first step in having a much improved quality of life,” she says, adding that people usually get a regimen they can follow at home once they've finished their work in the office.

The upside of being active is evident in a 2006 study. In it, 15 people with PAH exercised under supervision for 3 weeks and then exercised for 12 weeks at home. The other 15 folks in the study received standard care without exercise.

By the end of the 15-week study, those who exercised could walk about 315 feet farther in 6 minutes. Those who didn’t exercise lost about 49 feet. Plus, those who exercised also say their quality of life improved.

“Exercise outperformed medication alone, and the benefits were absolutely remarkable, not only in terms of walking and breathing better, but also in quality of life and being able to enjoy life,” Schilz says.

You might not do any rehab in a therapist's office. If you don’t get an at-home regimen after you finish pulmonary rehab, it's very important to talk to your doctor before you start working out at home.

Even if your specialist gives you a plan, there are dos and don’ts you should know.

“There is a fine line between pushing yourself too little and pushing yourself too much,” Awdish says. “A person with pulmonary hypertension should never exercise to a point where they just don’t feel good.”

Symptoms that signal you’re overdoing it include:

  • Severe shortness of breath
  • Feeling lightheaded
  • Chest pain

Some exercises are better for you if you have PAH. Good choices include:

  • Light aerobic activity, like walking or swimming
  • Light resistance training of small muscle groups like your hands, shoulders or feet.

But unless you have no symptoms, or the ones you have are very mild, don’t exercise your arms and legs at the same time, as you would on an elliptical machine, for example. And don’t lift, push, or shove anything heavier than 20 pounds. Those kinds of workouts raise the pressure in your arteries and lungs.

Don’t exercise outside when the weather is very hot and humid or frigid, either.

“Pulmonary hypertension doesn’t have a cure, but today we’ve come a long way in treatment, and people can live very well with the right medications and with activities like exercise,” says Schilz, who also serves on the Scientific Leadership Council of the Pulmonary Hypertension Association.

“I encourage any person with pulmonary hypertension to talk to their doctor and their health care team and find a way to get moving safely. Even a little bit of movement can go a long way.”