Physical activity for people with cardiovascular disease: recommendations of the National Heart Foundation of Australia

Tom G Briffa, Andrew Maiorana, Noella J Sheerin, Anthony G Stubbs, Brian F Oldenburg, Neville L Sammel and Roger M Allan
Med J Aust 2006; 184 (2): 71-75.


  • To provide physical activity recommendations for people with cardiovascular disease, an Expert Working Group of the National Heart Foundation of Australia in late 2004 reviewed the evidence since the US Surgeon General’s Report: physical activity and health in 1996.

  • The Expert Working Group recommends that:

    • people with established clinically stable cardiovascular disease should aim, over time, to achieve 30 minutes or more of moderate intensity physical activity on most, if not all, days of the week;

    • less intense and even shorter bouts of activity with more rest periods may suffice for those with advanced cardiovascular disease; and

    • regular low-to-moderate level resistance activity, initially under the supervision of an exercise professional, is encouraged.

  • Benefits from regular moderate physical activity for people with cardiovascular disease include augmented physiological functioning, lessening of cardiovascular symptoms, enhanced quality of life, improved coronary risk profile, superior muscle fitness and, for survivors of acute myocardial infarction, lower mortality.

  • The greatest potential for benefit is in those people who were least active before beginning regular physical activity, and this benefit may be achieved even at relatively low levels of physical activity.

  • Medical practitioners should routinely provide brief, appropriate advice on physical activity to people with well-compensated, clinically stable cardiovascular disease.

Please login with your free MJA account to view this article in full

  • Tom G Briffa1
  • Andrew Maiorana2
  • Noella J Sheerin3
  • Anthony G Stubbs4
  • Brian F Oldenburg5
  • Neville L Sammel6
  • Roger M Allan7

  • 1 School of Physiotherapy, Curtin University, Perth, WA.
  • 2 Royal Perth Hospital, Perth, WA.
  • 3 National Heart Foundation of Australia — NSW Division, Sydney, NSW.
  • 4 Queensland University of Technology, Brisbane, QLD.
  • 5 St Vincent's Hospital, Sydney, NSW.
  • 6 Prince of Wales Hospital, Sydney, NSW.



Organisations and their representatives who attended the open forum in February 2005 included: Dr Andrew Maiorana (exercise physiologist), representing the Australian Association of Exercise and Sports Science, and the Australian Cardiac Rehabilitation Association; Dr Rowan Vickers (general practitioner), representing the Australian Divisions of General Practice; Val McKenzie (general practice nurse), representing the Australian Practice Nurses Association; Dr Neville Sammel (cardiologist), representing the Cardiac Society of Australia and New Zealand, and The Royal Australian College of Physicians; Dr David Lim (general practitioner) and Professor Mark Harris, representing the Royal Australian College of General Practitioners (comments provided in absentia); Ms Belinda Cary representing the Australian Physiotherapy Association; Professor Kevin Norton representing Sports Medicine Australia. Honorary representatives of the Heart Foundation National Physical Activity Committee who contributed included Professor Bill Bellew (health promotion), Professor Adrian Bauman (public health; comments provided in absentia) and Professor Wendy Brown (chair; physical activity).

Competing interests:

None identified.

  • 1. United States Department of Health and Human Services. Physical activity and health: a report of the Surgeon General. Atlanta, Ga: USDHHS Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 1996.
  • 2. National Health and Medical Research Council. NHMRC additional levels of evidence and grades for recommendations for developers of guidelines. Canberra: NHMRC, 2005. Available at: (accessed Jun 2002).
  • 3. Thompson PD, Buchner D, Pina IL, et al. Exercise and physical activity in the prevention and treatment of atherosclerotic cardiovascular disease. Circulation 2003; 107: 3109-3116.
  • 4. Australian Institute of Health and Welfare. Heart, stroke and vascular diseases — Australian facts 2004. Canberra: AIHW, National Heart Foundation of Australia, 2004.
  • 5. Jolliffe JA, Rees K, Taylor RS, et al. Exercise-based rehabilitation for coronary heart disease. Cochrane Database Syst Rev 2000; (4): CD001800. Update in: Cochrane Database Syst Rev 2001; (1): CD001800.
  • 6. National Heart Foundation of Australia. NHFA physical activity recommendations for people with cardiovascular disease. Perth: NHFA, 2006.
  • 7. National Heart Foundation of Australia, Cardiac Society of Australia and New Zealand. Reducing risk in heart disease. Sydney: NHFA, 2003.
  • 8. Debusk RF, Stenestrand U, Sheehan M, Haskell WL. Training effects of long versus short bouts of exercise in healthy subjects. Am J Cardiol 1990; 65: 1010-1013.
  • 9. Smart N, Marwick TH. Exercise training for patients with heart failure: a systematic review of factors that improve mortality and morbidity. Am J Med 2004; 116: 693-706.
  • 10. Saunders DH, Greig CA, Young A, Mead GE. Physical fitness training for stroke patients. Cochrane Database Syst Rev 2004; (1): CD003316.
  • 11. Nehler MR, McDermott MM, Treat-Jacobson D, et al. Functional outcomes and quality of life in peripheral arterial disease: current status. Vasc Med 2003; 8: 115-126.
  • 12. Clausen JP, Trap-Jensen J. Heart rate and arterial blood pressure during exercise in patients with angina pectoris: effects of training and of nitroglycerin. Circulation 1976; 53: 436-442.
  • 13. Pina IL, Apstein CS, Balady GJ, et al. Exercise and heart failure, rehabilitation and prevention. Circulation 2003; 107: 1210-1225.
  • 14. Ivey FM, Macko RF, Ryan AS, Hafer-Macko CE. Cardiovascular health and fitness after stroke. Top Stroke Rehabil 2005; 12: 1-16.
  • 15. Oldridge N, Guyatt G, Jones N, et al. Effects on quality of life with comprehensive rehabilitation after acute myocardial infarction. Am J Cardiol 1991; 67: 1084-1089.
  • 16. Belardinelli R, Paolini I, Cianci G, et al. Exercise training intervention after coronary angioplasty: the ETICA trial. J Am Coll Cardiol 2001; 37: 1891-1900.
  • 17. Hiatt WR, Wolfel EE, Meier RH, Regensteiner JG. Superiority of treadmill walking exercise versus strength training for patients with peripheral arterial disease. Implications for the mechanism of the training response. Circulation 1994; 90: 1866-1874.
  • 18. Pescatello LS, Franklin BA, Fagard R, et al, American College of Sports Medicine. Position stand. Exercise and hypertension. Med Sci Sports Exerc 2004; 36: 533-553.
  • 19. Leon AS, Sanchez OA. Response of blood lipids to exercise training alone or combined with dietary intervention. Med Sci Sports Exerc 2001; 33 Suppl: S502-S515.
  • 20. American Diabetes Association, American College of Sports Medicine. Physical activity/exercise and diabetes. Diabetes Care 2004; 27 Suppl 1: S58-S63.
  • 21. Gordon NF, Gulanick M, Cosa F, et al. Physical activity and exercise recommendations for stroke survivors. Circulation 2004; 109: 2031-2041.
  • 22. Powell KE, Heath G, Kresnow MJ, et al. Injury rates from walking, weightlifting, outdoor bicycling, and aerobics. Med Sci Sports Exerc 1998; 30: 1246-1249.
  • 23. Franklin BA, Bonzheim K, Gordon S, Timmis GC. Safety of medically supervised outpatient cardiac rehabilitation exercise therapy: a 16-year follow-up. Chest 1998; 114: 902-906.
  • 24. National Heart Foundation of Australia, Australian Cardiac Rehabilitation Association. Recommended framework for cardiac rehabilitation. Melbourne: NHFA, 2004.
  • 25. Cardiac Society of Australia and New Zealand. Safety and performance guidelines for clinical exercise stress testing. Sydney: CSANZ, 2003.
  • 26. Petrella RJ, Lattenzio CN. Does counselling help patients get active? Systematic review of the literature. Can Fam Physician 2002; 48: 72-80.
  • 27. Gibbons RJ, Balady GJ, Bricker JT, et al. ACC/AHA 2002 Guideline update for exercise testing. Available at: (accessed Sep 2005).


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Responses are now closed for this article.