Coronary Heart Disease And Physical Activity

What is coronary heart disease?

Coronary Heart Disease (CHD), is also known as Coronary artery disease, ischemic heart disease (IHD), myocardial ischemia, or simply as “heart attack”. It is a heart condition that affects the blood flow and oxygen delivery to the heart muscle (myocardium). Its hallmark involves the formation of fatty material plaque, occluding the coronary arteries lumen and resulting in impairment of blood flow. Coronary Heart Disease is a major cause of death worldwide and has a diversified etiology. Some factors are non-modified, such as gender, family history, and genetics. Otherwise, modified factors include obesity, lipid levels, psychosocial variables, and smoking 7 

Can exercise help with coronary heart disease?

Regular physical activity prevents coronary heart disease. Many studies show the benefits of exercising. The higher the activity level is, the lower the cardiovascular risk, but it’s important to remember that exercise intensity is more significant to preventing heart disease than duration. However, even activities with low energy expenditure still reduce CHD risk compared to inactivity.7,8 

Physical activity prevents blood vessels from narrowing (anti-atherosclerotic) and blood clotting (anti-thrombotic), helps deliver blood to the heart (anti-ischaemic), and maintain a normal heart rhythm (anti-arrhythmic).1 Additional benefits for those with CHD include improved physical function and psychological wellbeing, and favorable changes in blood pressure, bad cholesterol (HDL), and insulin sensitivity.7 

Exercise helps strengthen the heart muscle

Exercise improves blood flow to the heart which reduces the risk of developing coronary heart disease.During exercise, skeletal muscle increases the need for blood perfusion (blood circulation through tissues), which provides oxygen. But not only do skeletal muscles increase the demand for oxygen, The myocardium also needs to have good blood flow. To supply this demand for oxygen and nutrients, the cardiac frequency, which is normally around 60-100 beats per minute, increases and can achieve more than 200 beats per minute. Different from other muscles, the maintenance of provided oxygen and nutrients in myocardium muscle depends on coronary artery flow.8  

Regular exercising not only induces changes that strengthen heart muscles but also promotes changes in heart vasculature that dilate coronary arteries, increase collateral artery formation, and consequently improve the blood flow.2 However, if you already have CHD, physical activity is still recommended. Regular exercise is as effective as many drug interventions with the advantage of avoiding the side effects of medications.5  

What kind of exercise is best for coronary heart disease?

Regular moderate-intensity exercise, or cardiac rehabilitation, has many benefits for CHD patients. Prescriptions consider an individual’s exercise capacity and risk profile under the supervision of physical therapists.    

Strength exercises

When you increase muscle mass, you also increase your energy expenditure. So, strength training controls weight and decreases cardiac needs during daily activities. Cardiac patients should begin with motion exercises, such as flexibility or stretching.9 

Low to medium intensity cardio

Aerobic training could be based on frequency and intensity. The frequency can be increased from 2 times a week to around 5 times a week during cardiac rehabilitation, and the intensity can gradually increase with supervision and based on heart rate. The recommendation is 20 to 60 minutes of continuous or intermittent activity, which can be broken into shorter periods of activity and should have recovery pauses. The most diverse activities can be done, from primary aerobic exercises (running, jogging, swimming, cycling) to secondary exercises working endurance sports like racquetball, tennis, or basketball.7,3

When to contact a doctor

The symptoms of coronary heart disease include chest pain (angina), shortness of breath,

pain throughout the body, and feeling faint and sick (nausea). Chest pain is often severe, but some people only experience minor pain, similar to indigestion. Another common characteristic is chest pain running down the left arm. A heart attack is a medical emergency, so if any of these symptoms appear suddenly, call an emergency number and ask for an ambulance.9


Physical activity is one of the most effective ways to prevent coronary heart disease (CHD), reducing mortality with no side effects. Also, regular exercise is used in cardiovascular rehabilitation, for conditioning, and for preventing a second event in CHD patients. Although the benefits are much greater than the risks, CHD patients should only exercise if clinically stable and supervised by a physical therapist.


  1. Shahjehan RD, Bhutta BS. Coronary Artery Disease. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022. Available from:
  2. Winzer EB, Woitek F, Linke A. Physical activity in the prevention and treatment of coronary artery disease. Journal of the American Heart Association [Internet].7(4):e007725. Available from:
  3. Anderson L, Oldridge N, Thompson DR, Zwisler AD, Rees K, Martin N, et al. Exercise-based cardiac rehabilitation for coronary heart disease: cochrane systematic review and meta-analysis. J Am Coll Cardiol. 2016 Jan 5;67(1):1–12. 
  4. Wienbergen H, Hambrecht R. Physical exercise and its effects on coronary artery disease [Internet]. Vol. 13, Current Opinion in Pharmacology. 2013. p. 218–25. Available from:
  5. Bruning RS, Sturek M. Benefits of exercise training on coronary blood flow in coronary artery disease patients. Prog Cardiovasc Dis. 2015 Mar;57(5):443–53.
  6. Naci H, Ioannidis JPA. Comparative effectiveness of exercise and drug interventions on mortality outcomes: meta-epidemiological study. BMJ. 2013 Oct 1;347:f5577.Available from:
  7. Yadav YK. Exercise in the management of coronary artery disease. Armed Forces Med J India. 2007 Oct;63(4):357–61.
  8. Coronary heart disease [Internet]. [cited 2022 Sep 9]. Available from:
  9. Heart attack [Internet]. [cited 2022 Sep 9]. Available from:

Dayene Caldeira

Masters and PhD candidate in Biological Sciences (Physiology), Federal University of Rio de Janeiro, BR

Visiting Researcher at Queen's University Belfast, UK.
Dayene is a scientific expert experienced in Clinical Data Management and Medical Communication. She has 6 years of experience in Publications, Grant submissions and Regulatory documents in the Medical Writing field. Currently, working with medical education and patient engagement, creating materials about different diseases and therapeutic areas. presents all health information in line with our terms and conditions. It is essential to understand that the medical information available on our platform is not intended to substitute the relationship between a patient and their physician or doctor, as well as any medical guidance they offer. Always consult with a healthcare professional before making any decisions based on the information found on our website.
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