Cardiovascular Disease

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Cardiovascular Diseases include those that have had an MI,revascularization, angina, atrial fibrillation, pacemakers and implanted defibrillators, valvular heart disease, chronic heart failure, cardiac transplant, hypertension. peripheral arterial disease and aneurysms.


The effects of medication

Fisher, K. and Jamnik, R. (2007) Exercise and medication: How do they interact? [www]

Peel, C., & Mossberg, K. A. (1995). Effects of cardiovascular medications on exercise responses. Physical therapy, 75(5), 387-396.[full text]

Other considerations


Exercise Intensity Considerations for clients with Cardiac Disease

  • Deconditioned and low capacity clients may need to start at low intensities
  • Target intensity should fall 10-15 beats per minute below a heart rate that has previously elicited abnormal clinical symptoms (ie chest pain or other angina symptoms)
  • β-blockers and other heart rate-lowering medications will decrease the accuracy of exercise intensity prescription methods based on an age-predicted maximal heart rate
  • RPE levels of 11 to 13 typically respond to the target heart rate for cardiac clients frst initiating an exercise program, RPE can be progressed (14-16) after several months of training when conditioning has improved and no complications are present.  
ACSM (2009)

Resistance Training Guidelines for clients with Cardiac Disease

ACSM (2009) Resources for Personal Trainers p 442


American College of Sports Medicine (2009) ACSM's Resources for the personal trainer. Philadelphia, PA: Lippincott, Williams & Wilkins
Further Reading
Archer, E., & Blair, S. N. (2011). Physical activity and the prevention of cardiovascular disease: from evolution to epidemiology. Progress in cardiovascular diseases, 53(6), 387-396. [full text]

Carabello, B. A. (2002). Evaluation and management of patients with aortic stenosis. Circulation, 105(15), 1746-1750. [full text]

Davies, E.J., Moxham, T., Rees, K., Singh, S., Coats, A.J.S., Ebrahim, S., Lough, F., Taylor, R.S.(2010) Exercise based rehabilitation for heart failure. Cochrane Database of Systematic Reviews, Issue 4. Art. No.: CD003331. DOI: 10.1002/14651858.CD003331.pub3 [full text]

Fletcher, G.F., Balady, G.J., Amsterdam, E.A., et al (2001) Exercise Standards for Testing and Training: A Statement for Healthcare Professionals from the American Heart Association. Circulation, Vol. 104, 1694-1740 [full text]


Heran, B. S., Chen, J. M., Ebrahim, S., Moxham, T., Oldridge, N., Rees, K., ... & Taylor, R. S. (2011). Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database Syst Rev, 7(7). [full text]

Leon, A.S., Franklin, B.A., Costa, F., Balady, G.J., Berra, K.A., Stewart, K.J., et al. (2005) Cardiac rehabilitation and secondary prevention of coronary artery disease:an American Heart Association scientific statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity), in collaboration with the American association of Cardiovascular and Pulmonary rehabilitation. Circulation 111:369–376 [full text]
Pischke, C. R., Scherwitz, L., Weidner, G., & Ornish D. (2008) Long-term effects of lifestyle changes on well-being and cardiac variables among CHD patients. Health Psychology.Vol.27, No.5, 584-92 [author’s text]
Thompson, P. D., Buchner, D., Piña, I. L., Balady, G. J., Williams, M. A., Marcus, B. H., ... & Wenger, N. K. (2003). Exercise and physical activity in the prevention and treatment of atherosclerotic cardiovascular disease a statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity). Circulation, 107(24), 3109-3116 [full text]
Further Links
American Heart Association -
BBC Health microsite - [click here]