Ten recommendations for exercise for patients with cardiovascular disease! European Heart Journal

Last August, the European Society of Cardiology (ESC) published its first-ever guidelines on exercise and physical activity for people with heart disease.

For details, please see: The most comprehensive exercise advice! ESC releases cardiovascular disease and exercise guidelines

Recently, the European Heart Journal summarized the guidelines and made the following "top ten recommendations":

1. All patients with cardiovascular disease should do their best to exercise for at least 150 minutes, 5 days a week, or 75 minutes of vigorous exercise, 3 days a week.

2. For people with obesity, hypertension or type 2 diabetes, it is recommended to perform an additional 20 minutes of strength training three times a week to reduce cardiovascular risk.

3. Preliminary identification of high-risk groups for atherosclerotic coronary artery disease through symptom assessment, identified risk factors, and systematic coronary risk evaluation (SCORE).

4. People at high risk of adverse cardiac events caused by atherosclerotic coronary artery disease should undergo risk stratification through exercise stress testing or functional imaging if they want to engage in high-intensity exercise.

5. Before prescribing exercise for patients with heart failure, it is essential to optimize medical therapy, assess function, and risk stratify.

6. Regular physical exercise is the cornerstone of preventing atrial fibrillation in the general population; however, lifelong endurance exercise may increase the risk of atrial fibrillation in some middle-aged and older men.

7. Asymptomatic patients with mild hypertrophic cardiomyopathy and a low 5-year risk score can participate in all competitive sports, except those in which syncope could result in potentially fatal trauma.

8. Patients with severe valvular heart disease, poor left ventricular function, arrhythmogenic cardiomyopathy and active myocarditis should not engage in high-intensity exercise.

9. Patients receiving anticoagulant therapy and with ICD implanted should avoid participating in activities that may cause potential trauma.

10. For individuals who are at risk for significant cardiovascular disease and wish to participate in high-intensity or competitive sports, shared decision-making is recommended to inform the individual of the effects of exercise and the potential risks of complications and/or adverse events.

Source: Sharma S, Pelliccia A, GatiS. The 'Ten Commandments' for the 2020 ESC Guidelines on Sports Cardiology and Exercise in Patients with Cardiovascular Disease. Eur Heart J. 2021 Jan1;42(1):6-7.

Reprinted from: China Circulation Magazine