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Cardiovascular diseases, including hypertension, coronary artery disease and congestive heart failure are some of the leading causes of mortality and hospitalization in Canada. These conditions affect upwards of 25% of the population.
Physical activity is an important lifestyle modification for cardiovascular disease risk reduction and health care professionals play an important role in conveying that message to persons at risk for and living with cardiovascular diseases. The prescription of exercise and physical activity by health care professionals to their clients has been documented as an effective way to get them more physically active.
Multiple studies have determined that exercise and physical activity are safe for persons diagnosed with cardiovascular diseases. Systematic reviews suggest exercise improves aerobic capacity, physical functioning, muscle strength, and health related quality of life. It can offer clinically significant benefits including:
- improved lipid profiles and insulin sensitivity
- improved coronary perfusion, cardiac capacity and efficiency
- improved systolic and diastolic blood pressure measurements
- reduced systemic inflammation
- reduction in all-cause mortality and potential future cardiac events
- improved exercise and functional capacity
- improved body composition
- improved mental wellbeing and reduced stress, anxiety and depressive symptoms
Physical Activity and Cardiovascular Diseases
It is important to assess each client for their personal cardiac risk factors prior to them commencing a new exercise program.
Current Canadian guidelines recommend persons diagnosed with cardiovascular diseases achieve 150 minutes of moderate- to vigorous-intensity physical activity each week. For optimal health benefits, it is recommended to include both aerobic and resistance exercise in prescriptions and recommendations.
Cardiac rehabilitation programs consisting of exercise classes are offered by community and recreation centres throughout British Columbia.
Persons with certain cardiovascular conditions should also be counselled to NOT participate in unsupervised exercise. These conditions include, but are not limited to, obstruction to left ventricular outflow, decompensated heart failure and unstable variable heart rate.
Certain cardiovascular disease medications (i.e., beta blockers) will regulate heart rate, therefore, perceived exertion is a better measure of cardiac demand for clients taking these medications.
Clients should be counselled to track their blood pressure if this is a concern. Exercise or physical activity should be stopped when systolic or diastolic pressures reach 200 or 115 mm/Hg respectively.
During resistance training, working muscles to exhaustion can cause significant spikes in blood pressure. The Valsalva maneuver during resistance exercise should be avoided as it can also cause significant spikes in blood pressure.
Physical Activity Counselling Toolkit (University of Alberta, Canada)
This Toolkit consists of handouts on physical activity for general health and various chronic conditions, including hypertension and chronic heart failure. The handouts are intended to be used by health care providers and/or qualified exercise professionals to support patients/clients to become more physically active.
Exercise based rehabilitation: Heart Failure (Royal College of Australian General Practitioners, Australia)
This resource offers specific guidelines for prescribing exercise to clients diagnosed with heart failure.
Physical Activity In the Treatment of Long Term Conditions (British Medical Journal, United Kingdom)
This online course covers exercise prescription for many chronic conditions including cardiovascular disease. It helps to understand why physical activity is an important part of cardiovascular disease management and how to help your clients get started with exercise. This course is free but does require you to register with them before accessing the course.
Physical Activity and Cardiovascular disease (Physiopedia, United Kingdom)
A webpage that reviews the benefits and parameters of exercise/physical activity prescription for persons living with cardiovascular diseases. Includes special considerations, recommendations and contraindications.
Physical activity in the prevention and treatment of disease (Swedish Institute of Public Health, Sweden)
This resource has comprehensive information about exercise prescription for clients with cardiovascular conditions within chapter 29 to 31.
Exercise and Acute Cardiovascular Events: Placing the Risks into Perspective (American College of Sports Medicine, USA)
An online publication that examines the risk of cardiac events when prescribing activity and exercise to clients with cardiovascular diseases.
Exercise for the Prevention and Treatment of Hypertension - Implications and Application (American College of Sports Medicine, USA)
A webpage that details the considerations for prescribing exercise for persons living with elevated blood pressure. It offers insight on both prescription and specific considerations related to elevated blood pressure.
Last updated: November 2021