Exercise may help improve heart health and overall fitness in people with heart failure. However, these individuals should get the approval of a healthcare professional before starting an exercise regimen.

The American Heart Association (AHA) notes that heart failure, or congestive heart failure, means that the heart has become weakened and is unable to pump blood as efficiently as it would usually.

As a result, the body might not get as much oxygen as it needs, and everyday tasks may feel more difficult.

Exercise can help strengthen the heart and improve how oxygen circulates through the body. People with heart failure will need to discuss an exercise program with a healthcare professional.

This article looks at the possible benefits of exercise for people with heart failure. It also discusses the suitable types of exercise and provides tips for exercising safely.

A person with congestive heart failure exercising in a gym.Share on Pinterest
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According to a 2017 article, exercise may reduce the risk of fatal cardiac events in people with heart failure. The authors note that inactivity, such as not exercising or having long periods of sedentary time, seems to increase the mortality risk in people with heart failure.

The authors add that the Heart Failure Association Guidelines recommend moderate, regular exercise for people with heart failure. This may help by:

  • reducing symptoms
  • improving the functional capacity of the heart
  • reducing the risk of hospitalization

People will need to check with a healthcare professional before starting an exercise program. Some exercises may not be suitable for people with certain heart conditions, such as:

  • obstruction to left ventricular outflow
  • decompensated heart failure
  • unstable variable heart rate

According to the American College of Sports Medicine (ACSM), the benefits of regular exercise for people with heart failure include:

  • increased function
  • reduced symptoms of heart failure
  • improved quality of life
  • increased ability to carry out everyday activities
  • retained independence
  • improved overall health and fitness

Other benefits of regular exercise may include:

  • increased energy levels
  • increased physical strength
  • increased endurance and ability to exercise
  • weight loss or maintenance
  • better management of any additional health conditions, such as high blood sugar, blood pressure, or cholesterol
  • stress management
  • improved sleep
  • improved mental health, such as reducing symptoms of depression or anxiety

Healthcare professionals emphasize the importance of “listening to” the body.

It is normal to experience the following when exercising:

  • feeling comfortable and relaxed
  • being aware of the breath but not out of breath
  • feeling slightly tired
  • feeling slightly sweaty

If people experience any of the following, they will need to stop exercising and contact a doctor:

  • chest discomfort
  • worsening shortness of breath
  • dizziness
  • nausea
  • rapid heart rate
  • extreme fatigue

It is essential to call a doctor or 911 if the following occur:

  • chest pain
  • swelling in the lower body
  • worsening dizziness or confusion
  • shortness of breath when resting

A combination of different exercise types may help benefit people with heart failure.

Moderate intensity resistance training

Resistance training, also known as strength training, involves making the muscles work against a force, which can be in the form of weights, resistance bands, or body weight. Resistance training can help work all the major muscle groups in the body.

Examples of resistance training include:

  • pushups
  • squats
  • chinups
  • exercises with hand weights
  • barbells
  • dumbbells

How often?

The ACSM recommends moderate intensity resistance training at least twice a week, which may help improve functional capacity and overall health. Lifting a weight 10–15 times counts as moderate intensity.

Cardio or aerobic exercise

Aerobic exercise helps improve circulation and lower blood pressure. It also helps control blood sugar.

A moderate level of exercise is one during which a person is still able to talk without being too out of breath.

Examples of aerobic exercise include:

  • brisk walking
  • cycling
  • swimming
  • jogging
  • tennis
  • jumping rope

How often?

People can begin with low to moderate aerobic exercise, aiming for at least 150 minutes per week.

It will likely be easiest to split this throughout the week, aiming to be active for at least 30 minutes on 5 days of the week.

Flexibility exercise

Flexibility, stretching, and balance exercises can complement aerobic and resistance training.

Flexibility exercise helps support the musculoskeletal system by reducing or preventing joint pain, cramping, and muscle aches.

Types of exercise that can boost flexibility include:

  • yoga
  • tai chi
  • stretching

How often?

People can do flexibility workouts every day, as well as before and after aerobic or resistance training.

Warming up and cooling down are important components of exercise.

Stretching before and after exercise can help reduce stress on the heart and muscles, as well as helping prevent injury.

The stages of exercise are as follows:

Warm up

The AHA recommends warming up as it helps with:

  • dilating blood vessels, ensuring a good supply of oxygen to the muscles
  • warming up the muscles to increase flexibility and efficiency
  • raising the heart rate gradually to reduce stress on the heart
  • increasing range of motion and reducing stress on the joints and tendons to help prevent injury

People can warm up for at least 5–10 minutes before exercising by:

  • stretching all major muscle groups
  • performing low intensity cardio that is similar to planned exercise — for example, gently jogging on the spot ahead of going for a run
  • warming up the whole body, such as by walking on a treadmill


This term refers to the exercise session itself, which may involve aerobic, resistance, or flexibility training. In some cases, a person may opt for a combination of different exercise types.

Cool down

Cooling down after exercise is important to help keep blood flowing through the body. Cooling down helps ensure that body temperature and heart rate lower gradually.

The AHA advises that stopping exercise suddenly may cause a rapid drop in heart rate and blood pressure, which can lead to lightheadedness or nausea.

People may wish to cool down by walking at a slow pace for 5 minutes or until the heart rate lowers below 120 beats per minute.

Stretching is a good way to reduce a buildup of lactic acid in the body, which can cause the muscles to cramp or feel stiff.

Tips for stretching include:

  • holding each stretch for 10–30 seconds
  • being able to feel the stretch without it being painful
  • avoiding bouncing the body when stretching
  • maintaining consistent breathing by inhaling when going into the stretch and exhaling while holding the position

People with heart failure can maximize their chances of exercising safely and maintaining a regular practice by:

  • finding exercise that is enjoyable and can take place at a suitable time
  • finding others to exercise with if this helps with motivation
  • breaking exercise up into sections, such as a short yoga routine upon waking and a lunchtime walk, if it is difficult to fit it into the day
  • avoiding giving up after missing a workout and just starting again the next day
  • avoiding exercising shortly after eating
  • avoiding exercises that require holding the breath
  • exercising in mild temperatures, as very cold, hot, or humid weather can make it more challenging
  • drinking plenty of water to stay hydrated
  • eating a nutritious, well-balanced diet
  • setting simple goals, such as improving mobility or everyday function
  • starting with low impact activities, such as walking or swimming
  • beginning with shorter sessions of 10–15 minutes and gradually building up the duration and frequency of exercise
  • pausing for breaks whenever necessary
  • using a pedometer or activity tracker to monitor progress

Exercise may benefit people with heart failure, as it can strengthen the heart and muscles while improving overall health and fitness.

People with heart failure should speak with a healthcare professional before starting any new exercise program. During the consultation, they can discuss any medication changes or health concerns.