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ISSA, International Sports Sciences Association, Certified Personal Trainer, ISSAonline, Heart Disease and Exercise – What You Need to Know

Heart Disease and Exercise – What You Need to Know

Reading Time: 5 minutes 15 seconds


DATE: 2022-06-17

Heart disease is the leading cause of death in the U.S. for women, men, and most adult populations. According to the Centers for Disease Control and Prevention, one in every four deaths in the U.S. can be blamed on heart disease.

Often known as the silent killer, heart disease doesn’t always have symptoms. High blood pressure, for instance, is a leading risk factor, yet causes no noticeable signs. There are several ways to reduce the risk of developing heart disease. One of the most important and effective is to exercise regularly.

What Is Heart Disease? 

Heart disease is a group of conditions that affect the heart, blood vessels, or both. Some aspects of heart disease are genetic. For instance, you might have a family history of high cholesterol. But, many causes are preventable. Unhealthy lifestyle factors, like obesity, a poor diet, smoking, and lack of exercise, increase the risk of developing many types of heart disease.

Coronary Artery Disease

Coronary artery disease is the most common underlying cause of heart disease. It occurs when arteries in the heart harden, narrow, and become blocked due to plaque buildup. The main causes of coronary artery disease are high cholesterol, high blood pressure, diabetes, smoking, and a sedentary lifestyle.

Heart Attack

A heart attack is not heart disease, but it is a common complication. It is one of the main consequences of coronary artery disease and occurs when a clot blocks the flow of blood to the heart. A heart attack can be fatal and can cause heart damage in survivors.

Heart Failure

Heart failure is exactly what it sounds like. It occurs when damage and weakness in the heart cause it to stop working properly. There is no cure for heart failure, but lifestyle changes and medications can extend life expectancy.


Arrhythmia is an irregular heartbeat, and there are several types. Genetic factors cause some cases of arrhythmia. Other causes and risk factors include tissue damage from a heart attack, coronary artery disease, diabetes, high blood pressure, medications, drug abuse, smoking, and stress. 

Heart Disease and Exercise – What Are the Benefits? 

There is no question that exercise is good for your heart. It is one of the best lifestyle changes anyone can make to improve heart health. The American Heart Association (AHA) recommends that adults get either 150 minutes of moderate-intensity exercise or 75 minutes of vigorous aerobic activity per week. Here’s why: 

  • Lower blood pressure. Exercise helps lower and control blood pressure, one of the biggest risk factors for heart disease. Physical activity strengthens the heart muscle, so it doesn’t have to pump so hard. This naturally decreases pressure on blood vessels. Exercise also increases the body’s production of nitric oxide, a compound that relaxes blood vessels. 

  • Change cholesterol levels. Blood cholesterol is another major indicator for heart disease. So called bad cholesterol, LDL, contributes to the plaque in arteries that causes coronary artery disease. It hardens and narrows the blood vessels. Higher levels of good cholesterol (HDL), on the other hand, is associated with a lower risk of heart disease. Regular exercise promotes the right balance of cholesterol, lowering LDL and raising HDL. Of course, diet is also essential for maintaining a healthy cholesterol blood level. 

  • Reduce heart attack fatalities. For some people, a lifetime of poor lifestyle choices leads to a heart attack, but they can still benefit from regular exercise. Studies show that heart attack patients who engage in guided exercise programs have a significantly reduced rate of death compared to those who do not. Exercise can reduce the death rate in this population by as much as 25%. 

  • Lose or maintain weight. Obesity is one of the top five risk factors for heart disease. Obesity contributes to heart disease in several ways: raising LDL cholesterol, increasing blood pressure, and causing diabetes. Being overweight or obese can also cause sleep apnea, which is associated with heart disease. Excess body fat can lead to atrial enlargement, swelling in the left side of the heart. This is both a result of and a risk factor for heart disease. 

  • Change body composition. While a healthy weight can reduce the risk of heart disease, body composition is also important. Even people with normal BMI (body mass index) can have too much body fat. Of particular concern is visceral fat, the fat around abdominal organs. Excessive visceral fat increases the risk of heart disease, but exercise and diet together can make a big impact. Strength training is especially important for changing body composition. 

In addition to aerobic workouts, the AHA recommends at least two strength training sessions per week. It also suggests that any kind of movement you can get throughout the day, even just walking around the house, is good for heart health. 

Here are some of the best exercises for heart health and reducing your risk of heart disease. 

Is it Safe to Exercise with Heart Disease? 

For most people with heart disease, not only is it safe to exercise, regular physical activity is beneficial. Someone with heart disease can benefit in all of the same ways healthy adults do: strengthening the heart muscle, lowering cholesterol and blood pressure, and managing weight. 

Patients with heart disease risk factors should always talk to their doctors before working out, but here is a guide for training clients with hypertension who have gotten the all-clear to exercise. 

The Benefits

It can be scary for someone with heart disease to begin a workout regimen. Their doctors are likely to prescribe exercise because of the many benefits, although they might provide some limitations. 

Exercise is a natural way to lower blood pressure and reduce blood cholesterol. It can help a cardiac patient lose or maintain a healthy weight. It can also prevent some types of arrhythmias. 

Although there are benefits, it makes sense to start slowly with these clients. They might be nervous about working out. Easing into exercise will make them feel safer. 

Cardiac Rehabilitation

Some heart patients are prescribed a type of exercise called cardiac rehabilitation. Cardiac rehab is medically supervised and designed to help patients recover from surgery, a heart attack, or other heart problems. 

Cardiac rehab usually begins while patients are still in the hospital. In the second stage, patients have gone home but come back in for rehab and physical therapy appointments. Stage three is to continue to exercise on their own, which is when a personal trainer can be useful.

Heart Disease and Exercise – Always Talk to Your Doctor First

As with any health condition, your clients must talk to their doctors before beginning training sessions. There might be reasons they should not workout, but more likely their doctors will suggest the safest exercises and any limitations. 

It is especially important for anyone who recently had a heart attack, has diabetes, has chest pains, or recently had heart surgery to get a doctor’s advice before working out. 

Listen to Your Body

If you have clients with heart disease, talk to them about listening to what their body is telling them. It’s perfectly normal to get out of breath, sweaty, and uncomfortable. Other symptoms could indicate they need to slow down or stop: chest pains, dizziness, cold and clammy skin, and getting unusually out of breath or experiencing an alarmingly high heart rate. 

If you have heart disease or risk factors, talk to your doctor and then consider hiring a personal trainer. It’s safer to work out with an expert and with approval from your doctor. With the right guidance, you can reduce your risk and improve heart health. 

Learn more about how exercise impacts and benefits health through the Certified Personal Trainer – Self-Guided Study Program. This online course will prepare you to become a certified trainer and to start helping clients meet health and fitness goals.  

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Heart Disease Facts. Centers for Disease Control and Prevention. (2022). Retrieved 3 June 2022, from https://www.cdc.gov/HeartDisease/facts.htm.

American Heart Association Recommendations for Physical Activity in Adults and Kids. www.heart.org. (2022). Retrieved 3 June 2022, from https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults.

Myers, J. (2003). Exercise and Cardiovascular Health. Circulation, 107(1). https://doi.org/10.1161/01.cir.0000048890.59383.8d

Too much belly fat, even for people with a healthy BMI, raises heart risks. www.heart.org. (2022). Retrieved 3 June 2022, from https://www.heart.org/en/news/2021/04/22/too-much-belly-fat-even-for-people-with-a-healthy-bmi-raises-heart-risks.

Encyclopedia, M., & disease, B. (2022). Being active when you have heart disease: MedlinePlus Medical Encyclopedia. Medlineplus.gov. Retrieved 3 June 2022, from https://medlineplus.gov/ency/patientinstructions/000094.htm.

Exercising when you have heart disease. Heart&Stroke. (2022). Retrieved 3 June 2022, from https://www.heartandstroke.ca/articles/exercising-when-you-have-heart-disease.

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