Heart Failure: Activity and Exercise

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Heart Failure: Activity and Exercise


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.

  • 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.
  • 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.1 Aim for at least 2½ hours of moderate exercise a week.2 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.

Continue to Why?


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 or improve:

  • 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.

Test Your Knowledge

Regular exercise will help me control my stress and depression.

  • True
    This answer is correct.

    Regular exercise will help you control your stress and depression.

  • False
    This answer is incorrect.

    Regular exercise will help you control your stress and depression.


Continue to How?


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 concerns to discuss with your doctor. An exercise planning sheet(What is a PDF document?) can help you do this. This sheet can include things like exercises you should not do, whether you need to change how you take your medicine, and your activity goals.
  • 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.
  • Learn how to check your heart rate. Your doctor can show you how to take your pulse and how fast it should be (target heart rate) 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

  • 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.

Test Your Knowledge

I may need one or more tests before I start an exercise program.

  • True
    This answer is correct.

    You may need one or more tests before you start an exercise program. Anyone who has heart disease may need special tests before starting an exercise program.

  • False
    This answer is incorrect.

    You may need one or more tests before you start an exercise program. Anyone who has heart disease may need special tests before starting an exercise program.


Continue to Where?


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.

If you would like more information on heart failure, the following resources are available:


American Heart Association (AHA)
7272 Greenville Avenue
Dallas, TX  75231
Phone: 1-800-AHA-USA1 (1-800-242-8721)
Web Address: www.heart.org

Visit the American Heart Association (AHA) website for information on physical activity, diet, and various heart-related conditions. You can search for information on heart disease and stroke, share information with friends and family, and use tools to help you make heart-healthy goals and plans. Contact the AHA to find your nearest local or state AHA group. The AHA provides brochures and information about support groups and community programs, including Mended Hearts, a nationwide organization whose members visit people with heart problems and provide information and support.

National Heart, Lung, and Blood Institute (NHLBI)
P.O. Box 30105
Bethesda, MD  20824-0105
Phone: (301) 592-8573
Fax: (240) 629-3246
TDD: (240) 629-3255
Email: nhlbiinfo@nhlbi.nih.gov
Web Address: www.nhlbi.nih.gov

The U.S. National Heart, Lung, and Blood Institute (NHLBI) information center offers information and publications about preventing and treating:

  • Diseases affecting the heart and circulation, such as heart attacks, high cholesterol, high blood pressure, peripheral artery disease, and heart problems present at birth (congenital heart diseases).
  • Diseases that affect the lungs, such as asthma, chronic obstructive pulmonary disease (COPD), emphysema, sleep apnea, and pneumonia.
  • Diseases that affect the blood, such as anemia, hemochromatosis, hemophilia, thalassemia, and von Willebrand disease.

National Institutes of Health Senior Health
9000 Rockville Pike
Bethesda, MD  20892
Phone: 1-800-222-2225 Aging Information Center
TDD: 1-800-222-4225
Email: custserv@nlm.nih.gov
Web Address: www.nihseniorhealth.gov

This website for older adults offers aging-related health information. The website's senior-friendly features include large print, simple navigation, and short, easy-to-read segments of information. A visitor to this website can click special buttons to hear the text aloud, make the text larger, or turn on higher contrast for easier viewing.

The site was developed by the National Institute on Aging and the National Library of Medicine, both part of the National Institutes of Health (NIH). NIHSeniorHealth features up-to-date health information from NIH. Also, the American Geriatrics Society provides independent review of some of the material found on this website.

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  1. Pina IL, et al. (2003). Exercise and heart failure: A statement from the American Heart Association Committee on Exercise, Rehabilitation, and Prevention. Circulation, 107(8): 1210–1225.
  2. U.S. Department of Health and Human Services (2008). 2008 Physical Activity Guidelines for Americans (ODPHP Publication No. U0036). Washington, DC: U.S. Government Printing Office. Available online: http://www.health.gov/paguidelines/guidelines/default.aspx.


ByHealthwise Staff
Primary Medical ReviewerRakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
Specialist Medical ReviewerStephen Fort, MD, MRCP, FRCPC - Interventional Cardiology
Last RevisedApril 26, 2012

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