Physical Activity

  • Exercise is essential for good cardiovascular health.
  • Having heart failure does not mean that you cannot exercise. In fact, studies show numerous benefits of exercise in people with heart failure.
  • Enrolling in a cardiac rehabilitation program may be an option for you. These programs are an excellent source of information and allow you to exercise in a supervised setting.
  • Ideally, you should be getting regular physical activity: 30 minutes per day, five days per week. You may need to gradually build up to this level of activity.

Exercise and Heart Failure



Exercising regularly helps people with heart failure live longer, improves quality of life, and decreases the need for heart failure related hospital admissions. Other health benefits: 

  • Better energy levels
  • Increased physical strength and ability to exercise
  • Weight loss
  • Improved management of other medical conditions and risk factors, such as diabetes, blood pressure, and cholesterol levels
  • Management of stress
  • Improved quality of sleep
  • Decreased symptoms of depression.


Is it safe for me to exercise?

You may feel uncertain about starting to exercise. The first step is to talk to your health care provider to find out if it is safe for you to exercise, what type of exercise or program is best for you and how much. 

Your doctor may order a cardiopulmonary exercise test to determine a safe level of exercise for you.

How should I start exercising?

Starting to exercise for the first time or resuming exercise after a long break can be hard at first. It is best to start slowly, go step-by-step, and take breaks whenever you need them. Also, it is important to monitor how you feel during exercise. 

Tips to start a regular exercise routine:

  1. Plan to start exercising two to three days each week. Slowly work your way up to an end goal of exercising five days each week.
  2. Start by exercising for 10-15 minutes at a time. Slowly build up the time you are exercising. Your end goal should be to exercise for 30 minutes.
  3. Always make sure that you begin and end your exercise with a five minute ‘warm-up’ and ‘cool-down.’ Perform stretching exercises after your “cool down” is complete. This will help to reduce the stress on your heart and muscles and prevent injury.
  4. Make an exercise schedule for each week and try and stick to it.
  5. Use a diary or journal to track your exercise routine and how you are feeling during exercise. 
  6. Use a self-monitoring tool, such as the Borg Rating of Perceived Exertion (RPE) Scale, to help measure how you feel during exercise. The Borg RPE is a numerical scale that you can use to monitor how hard you are working during exercise. The goal is to be between three and five on the scale.



Aerobic Exercise
Aerobic exercise can improve your cardiovascular fitness by improving how your body utilizes oxygen to give you energy.

Moderate intensity aerobic exercise is best for the cardiovascular system. You can try: 

  • Brisk walking
  • Swimming
  • Cycling (either outdoor or on a stationary bike)
  • Water aerobics
  • Fitness classes such as Zumba 
  • Dancing.
Strength or Resistance Training
Strength or resistance training improves muscle mass and tone and enhances quality of life. To add this type of training to your exercise routine: 

  • Use light free weights (no more than 5-10 lbs.) or resistance bands
  • Do short sessions of 10-20 repetitions with the light free weights, two to three times per week.
Cardiac Rehabilitation
Joining a cardiac rehabilitation program is an excellent way to learn how to exercise and is recommended for all patients with stable heart failure.

Cardiac rehab will provide you with an ‘exercise prescription’ that is tailored to your health needs. While in cardiac rehab, you will be supervised during exercise. You will receive training on how to exercise safely, monitor your symptoms during exercise, and reach your individual exercise goals. For those people who cannot attend on-site, home-based programs are also offered which include ongoing contact with exercise specialists.

Cardiac rehab also provides education and support on how to manage risk factors for heart disease, such as eating a healthy diet and losing weight.

Learn more about UHN’s Cardiac Rehab Program.

or speak to your doctor about being referred to a program in your area.

When Should You Not Exercise?
You should not exercise if you have any of the following:

  • Feelings of unwellness, such as cold or flu symptoms
  • Worsening fatigue
  • Chest discomfort
  • Worsening shortness of breath or cough
  • Interrupted sleeps due to shortness of breath
  • Increased weight due to fluid build-up
  • Increased swelling in the feet, ankles, legs, or belly
  • Nausea or loss of appetite
  • An irregular heartbeat or if you feel your heart is beating too fast or slow
  • Dizziness.
Tips for Exercising Safely
  • If during exercise you develop chest discomfort, worsening shortness of breath, dizziness, nausea, or a fast heart rate, stop exercising and speak to your health care provider.
  • Don’t exercise in extreme temperatures, such as days when it is very cold, hot, or humid. In this weather, it is best to exercise indoors.
  • Wait at least 60-90 minutes after eating a meal before exercising.
  • Avoid exercises that involve holding your breath or bearing down, such as pushups and sit ups.

Keeping Cool with Heather
In this video, resident golf expert Heather Cartwright on how to deal with the heat and humidity during your outdoor activities. 

Energy Conservation
Fatigue is a common symptom of heart failure. Energy conservation is about maintaining a healthy balance between activity and rest to keep up your energy level. To help you learn how to use your energy wisely, here are some useful strategies. 

Plan ahead 

  • Make a schedule for the day and week ahead. 
  • Avoid trying to do all your chores in one day and rushing around. 
  • Plan shopping trips during times when there are fewer crowds or long lines. 
  • Simplify meal planning and stock your pantry with key ingredients for your favourite recipes. 
  • Get extra rest the day before attending a social event. 

Performing daily activities 

  • Break up larger activities into smaller parts and rest in between. 
  • Sit rather than stand when grooming, dressing, or putting on shoes. Sitting helps to give your heart a rest. 
  • Avoid standing for long periods of time. 
  • Be aware of your body posture, as poor posture can cause you to feel tired. Sit in a well-supported chair and avoid bending over when working at a desk. 
  • If you have stairs in your home, organize your activities so you don’t have to climb stairs several times each day. 
  • Learn to breathe evenly during activity and avoid holding your breath. 
  • Use equipment such as a walking device. 
  • Develop good sleep habits. If you nap for too long during the day you may not be able to sleep well at night. Avoiding eating before bed.
  • Avoid doing activities in extreme temperatures, such as very cold or hot weather, as this may cause you to feel more tired. 

Learn to listen to your body 

  • Recognize when you are starting to feel fatigued and take a break or short nap. 
  • Some people feel more energetic in the morning compared to the afternoon. Determine your best time of day to plan activities.