Myth #5
Exercise: not a helpful tool for heart failure?
False! The fact is, being sedentary causes more damage to your heart health, whether you already have heart failure or not!
Let's first clarify: what exactly is heart failure (HF)?
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The risk of HF increases with age, with a lifetime risk of 38% at 90 years of age (Magnussen et al., 2019).
When going about daily tasks, HF patients can be easily fatigued and get breathless. They may also experience other symptoms like swelling of the ankles and feet, and being breathless when they lie flat. So it seems normal for one with HF to cry out, "Exercise is useless. It only makes me feel worse." Especially so for the elderly when even the slightest physical exertion can seem like an uphill task.
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Exercise for managing heart failure
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However, as with all kinds of medicine, there are boundaries in adopting regular exercise. All exercises are to cease whenever experiencing the following warning symptoms:
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What activities are recommended? All movements are welcome, provided symptom-free!
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Exercise for preventing heart failure
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Besides, regular exercise confers protection against hypertension, obesity, and elevated blood glucose level -- all of which are risk factors for heart diseases and of course, HF. Studies have shown a cause-and-effect relationship between increased physical activity levels and cardiovascular mortality.
As sedentary people, how can you start reaping the “hearty” benefits? It is recommended to embark on exercise training from light to moderate intensity and gradually progress to vigorous intensity. Similar to HF patients, the goal is not to overexert the heart by starting immediately with vigorous exercise. Remember, the least active, least fit individuals are at the highest risk for exercise-related cardiac events.
Exercise, after all, is perhaps the cheapest and safest treatment and protection for HF! Let’s all get moving!
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"Failure" suggests that something is out of function, so HF essentially refers to the heart's weakened ability to pump blood. With the reduced pumping capability comes an inadequate supply of blood to carry nutrients and oxygen to support the rest of the body.
![](https://static.wixstatic.com/media/b060c8_0681ae16317f4d6881c731912fc622d9~mv2.png/v1/fill/w_287,h_290,al_c,q_85,usm_0.66_1.00_0.01,enc_auto/b060c8_0681ae16317f4d6881c731912fc622d9~mv2.png)
So, how can exercise help? Strong scientific evidence supports the safety of supervised exercise and its benefits in reducing adverse outcomes. It has been shown that exercise and physical activity improves both heart function and muscle strength.
By regular training, HF patients can expect to experience reduced breathlessness and muscle fatigue when conducting daily activities. Cardiorespiratory fitness, as measured by peak oxygen consumption will improve too. It is an independent predictor of outlook and death in cardiac patients. Through exercise, HF patients can enjoy delayed disease progression.
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![](https://static.wixstatic.com/media/b060c8_920303912c7346eca227bf93fa885125~mv2.png/v1/fill/w_183,h_248,al_c,q_85,usm_0.66_1.00_0.01,enc_auto/b060c8_920303912c7346eca227bf93fa885125~mv2.png)
But remember to avoid unfamiliar and vigorous activities. Overdoing is no-fun as it can result in extensive death of heart cells, worsening HF, or sudden cardiac death. Overloading a failing heart is like asking a small bird to carry an elephant, what you probably get is a fainting bird and a still-standing mammal.
![](https://static.wixstatic.com/media/b060c8_ddb5c95391a24a00b332c7f62ec92161~mv2.png/v1/fill/w_295,h_254,al_c,q_85,usm_0.66_1.00_0.01,enc_auto/b060c8_ddb5c95391a24a00b332c7f62ec92161~mv2.png)
One way that ageing takes a toll on the heart is the increasingly stiff heart walls. This stiffness directly reduces the heart's capacity for pumping and predisposes it to failure. An increasingly rigid spring cannot contract and relax normally. For healthy people, regular exercise can reverse this harmful ageing process on the heart.
Designed using resources from Flaticon.com
Designed using resources from Flaticon.com
Written by: Fan Jiahui
References ​
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Franklin, B. A., Thompson, C. P. D., Al-Zaiti, S. S., Albert, C. M., Hivert, M. F., Levine, B. D., Lobelo, F., Madan, K., Sharrief, A. Z., & Eijsvogels, T. M. H. (2020). Exercise-related acute cardiovascular events and potential deleterious adaptations following long-term exercise training: Placing the risks into perspective-an update: A scientific statement from the American Heart Association. In Circulation. https://doi.org/10.1161/CIR.0000000000000749
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Hieda, M., Sarma, S., Hearon, C. M., MacNamara, J. P., Dias, K. A., Samels, M., Palmer, D., Livingston, S., Morris, M., & Levine, B. D. (2021). One-Year Committed Exercise Training Reverses Abnormal Left Ventricular Myocardial Stiffness in Patients With Stage B Heart Failure With Preserved Ejection Fraction. Circulation, 144(12), 934–946. https://doi.org/10.1161/circulationaha.121.054117
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Howden, E. J., Sarma, S., Lawley, J. S., Opondo, M., Cornwell, W., Stoller, D., Urey, M. A., Adams-Huet, B., & Levine, B. D. (2018). Reversing the Cardiac Effects of Sedentary Aging in Middle Age-A Randomized Controlled Trial: Implications for Heart Failure Prevention. Circulation, 137(15), 1549–1560. https://doi.org/10.1161/CIRCULATIONAHA.117.030617
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Magnussen, C., Niiranen, T. J., Ojeda, F. M., Gianfagna, F., Blankenberg, S., Vartiainen, E., Sans, S., Pasterkamp, G., Hughes, M., Costanzo, S., Donati, M. B., Jousilahti, P., Linneberg, A., Palosaari, T., de Gaetano, G., Bobak, M., den Ruijter, H. M., Jørgensen, T., Söderberg, S., … Schnabel, R. B. (2019). Sex-Specific Epidemiology of Heart Failure Risk and Mortality in Europe: Results From the BiomarCaRE Consortium. JACC: Heart Failure, 7(3), 204–213. https://doi.org/https://doi.org/10.1016/j.jchf.2018.08.008
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Morris, J. H., & Chen, L. (2019). Exercise Training and Heart Failure: A Review of the Literature. Cardiac Failure Review, 5(1), 57–61. https://doi.org/10.15420/cfr.2018.31.1
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Nayor, M., & Vasan, R. S. (2015). Preventing heart failure: the role of physical activity. Current Opinion in Cardiology, 30(5), 543–550. https://doi.org/10.1097/HCO.0000000000000206
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Pinckard, K., Baskin, K. K., & Stanford, K. I. (2019). Effects of Exercise to Improve Cardiovascular Health. Frontiers in Cardiovascular Medicine, 6(June), 1–12. https://doi.org/10.3389/fcvm.2019.00069
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Slimani, M., Ramirez-Campillo, R., Paravlic, A., Hayes, L. D., Bragazzi, N. L., & Sellami, M. (2018). The Effects of Physical Training on Quality of Life, Aerobic Capacity, and Cardiac Function in Older Patients With Heart Failure: A Meta-Analysis . In Frontiers in Physiology (Vol. 9, p. 1564). https://www.frontiersin.org/article/10.3389/fphys.2018.01564