®Walking
Walk on a level path at a pace at which you can still talk. Start slowly for a few minutes and slow down again to finish. Short walks during the day count too.
Start with 5–10 minutes; aim for 30 minutes on at least 3–5 days a week31%Reduction in the risk of hospital admission in the first 12 months with exercise-based rehabilitation (60 trials, 8,728 people)
1 in 13One hospital admission was prevented for roughly every 13 people who took part in rehabilitation
150 minWeekly target for moderate activity; it can be split into bouts of 5–10 minutes
56 millionPeople estimated to be living with heart failure worldwide in 2019
Symptoms
- Breathlessness during everyday tasks or when lying down; getting more out of breath than expected when you move.
- Weakness, tiredness, and light-headedness or dizziness, especially after activity.
- Swelling in the feet, ankles, legs or abdomen; feeling bloated.
- Sudden weight gain.
- A cough at night.
The most common causes of heart failure are coronary heart disease and high blood pressure. The number of people living with heart failure worldwide more than doubled between 1990 and 2019.
Who can exercise?
- The European Society of Cardiology recommends exercise for every person with heart failure who is able to exercise, to improve exercise capacity and quality of life and to reduce hospital admissions.
- For those with more severe disease, frailty or other conditions, it states that a supervised rehabilitation programme should also be considered.
- In the UK, cardiac rehabilitation is recommended for everyone diagnosed with heart failure; you should be referred for an assessment to learn how to exercise safely.
Talk to your cardiologist before you start. They will decide when to start and at what intensity, based on the state of your heart and your medicines.
What does the research show?
A Cochrane review published in 2023 looked at 60 randomised controlled trials involving 8,728 people with heart failure. Exercise-based cardiac rehabilitation reduced the risk of hospital admission for any cause in the first 12 months by 31%: roughly one admission was prevented for every 13 people. Quality of life improved to a clinically meaningful degree in the short term, and the improvement continued in the long term. No clear difference in the risk of death was shown. Programmes in a centre, at home (including digitally supported programmes) and a mix of the two all brought benefit.
Exercise does not cure heart failure and does not replace your medicines. Keep taking your medicines as your doctor has told you; exercise is one part of your treatment.
To exercise safely
- Warming up and cooling downStart each session slowly and let your heart rate rise gradually; at the end, slow down to finish. Do not lie down straight after exercise.
- The talk testAt moderate intensity you feel a little warmer and breathe faster, but you can still say a full sentence. If you cannot talk, you are pushing too hard.
- Little and oftenThe target is at least 150 minutes a week; you can start with bouts of 5–10 minutes a day. A little activity is better than none.
- Light strengtheningUse light weights, resistance bands, or unopened tins and water bottles; move slowly, do not hold your breath, and breathe out as you lift.
- Rest on bad daysDo not exercise on days when you feel unwell, or more tired and breathless than usual; on good days, do not overdo it either.
- Stop straight awayStop exercising if you have palpitations, severe breathlessness, chest pain, light-headedness, or feel that your energy has run out.
Exercises at home
Six gentle exercises for heart failure
These movements are gentle examples you can do at home once your cardiologist has allowed you to exercise; the choice of exercises and numbers of repetitions are general suggestions, and your rehabilitation team’s programme comes first. If standing is tiring, start with the seated movements.
Seated marching
If standing is tiring: sit upright on a sturdy chair, lift and lower your knees one at a time, and swing your arms as well. You can also use this to warm up.
2–5 minutesSit-to-stand from a chair
Sit at the front of a sturdy chair. Stand up as you breathe out, and sit down slowly as you breathe in. Use your hands for support if you need to.
8–10 reps, 1–2 setsHeel raises holding the counter
Hold lightly onto a worktop. Raise both heels together to rise onto your toes, then lower slowly. Do not hold your breath.
10 reps, 1–2 setsBiceps curl with a light weight
Sit upright. Hold a light weight, a full water bottle or an unopened tin. Bend your elbow to lift the weight towards your shoulder, then lower it slowly. Breathe out as you lift.
8–10 reps with each armSeated knee extension
Sit upright on a chair. Slowly straighten your knee and tighten the muscle at the front of your thigh, hold for 3 seconds, then lower.
8–10 repetitions with each legWeigh yourself every day
Weigh yourself every morning at the same time, on the same scales and in light clothing, and write the result down. A gain of about 2 kilos over 3–4 days may be a sign of fluid building up in your body; let your doctor or heart failure nurse know.
Salt and fluids
Do not add salt to your food, limit salty foods, and do not use salt substitutes without asking your doctor. One UK hospital leaflet recommends about 2 litres of fluid a day unless you are told otherwise; your team will decide the right amount for you. Stop smoking, cut down on alcohol and have your flu jab.
Frequently asked questions
Will exercise strain my heart?
Exercise at the right intensity does not strain the heart; by helping your muscles and lungs work more efficiently, it reduces the load on your heart during everyday tasks. The British Heart Foundation says regular activity can improve symptoms and quality of life and reduce the risk of hospital admission. But exercise does not cure or reverse heart failure; you need to keep taking your medicines.
How much, and how hard?
In the UK, adults are advised to do at least 150 minutes of moderate activity a week; this can be split into short bouts of 5–10 minutes a day. At moderate intensity you feel a little warmer and breathe faster, but you can keep talking. An Australian heart failure programme gives a target of 9–13 on a 6–20 exertion scale, that is, between “very light” and “somewhat hard”; rest if an activity feels hard.
Should I exercise in a centre or at home?
In a 2023 Cochrane review combining 60 studies, exercise-based cardiac rehabilitation was beneficial in centre-based, home-based (including digitally supported) and hybrid programmes. The European Society of Cardiology recommends that a supervised programme be considered for people with more severe disease, frailty or other conditions. You can choose whichever you can keep attending regularly; a home programme also needs your doctor's approval and follow-up.
Which exercises should I avoid?
Heavy lifting, straining while holding your breath, and movements that carry your whole body weight, such as push-ups and planks, are not recommended. Take care when swimming; exercise in water can be more tiring than it feels. If your symptoms have recently got worse, do not exercise in water.
On which days should I not exercise?
Do not exercise on days when you feel unwell, or more tired or breathless than usual. If you have put on weight quickly or your ankles are more swollen, check with your team first. On good days, do not overdo it either; you can choose the time of day when you feel most energetic.
Why should I weigh myself every day?
In heart failure, fluid can build up in the body, and the first sign of this is often sudden weight gain. Weigh yourself every morning at the same time, on the same scales and in light clothing, and write the result down. If you gain about 2 kilos over 3–4 days, let your doctor or heart failure nurse know.
For exercise after a heart attack, stent or bypass, see the cardiac rehabilitation page; to measure your pulse, see the pulse counter page.
When to seek help right away
In situations marked “emergency”, call 112; do not drive yourself to hospital:
- Severe breathlessness: gasping, a feeling of choking, being unable to speak (emergency)
- Pale, blue or grey lips or skin (emergency)
- Fainting, or not responding normally to your surroundings (emergency)
- Sudden or very severe symptoms, such as chest pain or gasping for breath (emergency)
- Breathlessness when lying down or during everyday tasks, frothy pink phlegm, sudden weight gain (see a doctor the same day)
- New or increased ankle or leg swelling, waking at night coughing or short of breath, or needing more pillows to breathe comfortably (tell your doctor soon)
Sources
- Molloy CD, Long L, Mordi IR, et al. Exercise-based cardiac rehabilitation for adults with heart failure – 2023 Cochrane systematic review and meta-analysis. Eur J Heart Fail. 2023;25(12):2263–2273.
- McDonagh TA, Metra M, Adamo M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021;42:3599–3726. Summary: Hadjiphilippou S, Lane R. Guidance on lifestyle, rehabilitation and devices in heart failure patients. Br J Cardiol. 2022;29(suppl 2):S13–S16.
- National Institute for Health and Care Excellence. Chronic heart failure: the care you should expect. NICE guideline NG106.
- NHS. Symptoms of heart failure and Treatment. Page last reviewed 26 June 2026.
- British Heart Foundation. Exercise for heart failure. Heart Matters, updated 27 January 2026.
- University Hospitals Birmingham NHS Foundation Trust. Top tips for heart failure patients. PI25/3263/04, June 2025.
- Queensland Heart Failure Services. Heart failure patient information: exercise sheets. Revised May 2010.
- Berkshire Healthcare NHS Foundation Trust. Heart failure. 2026.
- Liu Z, Li Z, Li X, et al. Global trends in heart failure from 1990 to 2019: an age-period-cohort analysis from the Global Burden of Disease study. ESC Heart Fail. 2024;11(5):3264–3278.