Exercise and Pulmonary Hypertension

By Cheryl Switzer


If you’ve searched the Internet for advice about exercising and pulmonary hypertension, you probably have not found much. There is a very simple reason for this. There is no such thing as a standard PH patient and therefore no “one size fits all” exercise plan appropriate for everyone.

In general, gentle or moderate regular exercise for stable PH patients is beneficial to everyone, including those with severe pulmonary hypertension. Toned muscles utilize oxygen more efficiently than flabby muscles. Also, prolonged periods of inactivity can lead to depression.  But perhaps the most compelling reason for people with PH to adopt a regular exercise program is an expected improvement in their PH symptoms.

Before you jump on that treadmill, you do need to discuss your activities with your physician BEFORE you begin a program.   You should not be exercising if you are a new PH patient with a disease that is not yet stable and/or controlled. 

In their article Exercise Training in Pulmonary Hypertension - Implications for the Evaluation of Drug Trials, John H. Newman, MD and Ivan M. Robbins, MD of Vanderbilt University describe their findings in a study to compare the benefits of a carefully monitored exercise program with that of various PH medications for a group of thirty patients. The findings of the study were surprising. The authors summarize it this way, “This is an important study that shows that exercise training can have an impact on short-term functioning and well-being in selected patients with PH that is equal to the best current drug therapies.”

Here are a few tips to ensure your safety and a positive outcome in getting off that couch:

 

  • Discuss your limitations and capabilities with your PH specialist. Talk to your doctor before you begin exercising to learn what you should and should not do to improve your exercise tolerance.
  • Start slowly. If you’ve been a couch potato for years, it will take time to build up your stamina. Don’t be impatient.
  • Avoid some activities. You do not want to work your upper and lower body at the same time (e.g.. a rowing machine). Lifting small weights to strengthen your upper body is fine and leg lifts are fine, just don’t do them at the same time. Your doctor may also probably tell you to avoid exercise that requires your arms to be raised over your head as this makes the heart work harder.
  • Don’t push yourself too hard. You never want to exercise to the point where you are too short of breath to speak, experience chest pain, or feel light-headed or dizzy.
  • Don’t be alone when you are getting started in your training program. It’s best to begin to exercise in a clinical setting where you can be monitored closely, but if that is not practical, make sure someone is with you ( e.g.. a family member or friend) when you are getting started.
  • Avoid exercising out-of-doors if the temperature is either too hot or too cold.
  • Stop exercising immediately if you begin to feel unwell.
  • If you have a pulse oximeter for home use, test yourself often. Choose a pace that keeps your blood saturation in the 90’s.

 

Your plan does not have to be elaborate. Anything you do to get moving is a good thing. Maybe just walking the aisles of your favorite market several times a week instead of taking the store’s scooter would be a good way to begin. As the study cited above shows, exercise can be as effective as a drug and think about this: there is no co-pay either.

For Further Reading
The Best Yoga Exercises for Pulmonary Hypertension (Source: Mayo Clinic)

Sources:
Primary Pulmonary Hypertension Exercise Guidelines


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