Exercise and heart disease: what do the ESC guidelines say?



The first ESC recommendations on sport and physical activity in patients with cardiovascular disease were presented during the virtual meeting of the European Society of Cardiology and published in the European Heart Journal (1).

The results of the work of the ESC task force, chaired by Antonio Pelliccia of the Institute of Medicine and Sports Science in Rome and by Sanjay Scharma of St. George’s University in London, demonstrate how regular exercise not only helps prevent heart disease, but it also reduces premature death in those people with a diagnosis of known heart disease.

  1. In fact, the possibility that physical exercise triggers a cardiac arrest or a heart attack is very low.
  2. Of course, all people who have been inactive for a long time and those with advanced heart disease should consult their doctor before starting any type of physical activity.
  3. From free-time exercise to competitive sports, the document examines all types of physical activity in people with heart disease and conditions that increase cardiovascular risk (such as obesity and diabetes).

The document also collected useful recommendations for physical exercise during pregnancy or in particular settings, such as at high altitudes, in particularly polluted areas or with extreme temperatures.

Therefore, in people with known heart disease (just like in healthy subjects of all ages), it is almost daily physical activity of moderate intensity (for a total of at least 150 minutes a week) to be recommended.

To understand what is meant by “moderate intensity”, we must think of a physical exercise that increases our heart and respiratory rate without making it impossible to have a normal conversation.

  • For obese, hypertensive or diabetic subjects, the guidelines recommend adding strengthening exercises (lifting light weights) to aerobic exercise at least three times a week.
  • Regarding the most common cardiovascular disease, coronary heart disease, there is no contraindication to the practice of competitive or amateur sports, which should instead be encouraged with a personalized prescription.

Benedetta Ferrucci

1. What the evidence saysFur A, Sharma S, Gati S, et al. 2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease: The Task Force on sports cardiology and exercise in patients with cardiovascular disease of the European Society of Cardiology (ESC).

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Simona Giampaoli, Chiara Donfrancesco, Luigi Palmieri, Serena Vannucchi, Anna Di Lonardo, Cinzia Lo Noce, Claudia Meduri – Department of Epidemiology of brain and cardiovascular diseases, Cnesps-Iss

What the evidence says

June 9, 2016 – As recommended by the World Health Organization (WHO), on the basis of strong and consolidated scientific evidence, a consumption of salt of less than 5 grams of salt per day is recommended in the diet (more or less those contained in a teaspoon), which corresponds to about 2 grams of sodium [1].

In fact, table salt (or sodium chloride, NaCl) promotes the increase in blood pressure, the main cause of heart attack and stroke, kidney stones, osteoporosis, some cancers, especially stomach cancer.