Because pulmonary arterial hypertension (PAH) often causes shortness of breath, swelling, and fatigue, exercise seems like the last thing you should do. But the right kind — with your doctor’s approval — can ease symptoms and improve quality of life.
Almost however you cut it, exercise is good medicine.
“We’re calling sitting the new smoking,” says Eugene Chung, MD, chair of the American College of Cardiology Sports and Exercise Cardiology Leadership Council and professor of internal medicine at the University of Michigan. “If you lead a sedentary lifestyle, the biggest bang for your buck from a health standpoint is getting up and moving more often.”
Regular exercise helps your heart and body work smarter, not harder. It keeps your blood vessels in good shape and reduces inflammation. All of this has a positive effect on PAH.
Here’s how it works: PAH puts a strain on the right ventricle. This stress triggers a cascade of changes in your body. One is a rush of adrenaline, the hormone that triggers your “fight-or-flight” response.
“Multiple studies have shown that exercise helps reduce inflammation and trains the heart to respond to the adrenaline rush,” says Chung.
This improves your maximum training heart rate. That’s how many beats per minute your heart can safely pump when exercising. It also lowers your blood pressure, which helps prevent the cascade of changes from happening in the first place.
In short, exercise helps break the cycle of worsening PAH symptoms.
“Any exercise program should be started in consultation with your doctors, and you should be monitored regularly,” says Chung.
Your doctor understands your limitations and can tell you what’s okay. Ideally, you’ll exercise under the supervision of a cardiopulmonary rehabilitation program. As for the type of exercise that’s best, Chung says they focus on aerobic activity. These are the kinds that get your heart pumping, not isometric movements that force you to hold your muscles in a contracted position, or high-resistance exercises like weightlifting.
To get your blood pumping, you can try the following:
Walk. Get your steps on a treadmill or take a brisk walk around your neighborhood. Aim for one-hour sessions three times a week.
To swim. Exercising in the water tones your muscles without putting stress on your joints. You can do aqua aerobics or just swim laps.
To go biking. Elliptical trainers and recumbent bikes are a safe way to ride a bike without risking a fall.
Other types of exercises are:
yoga. Although there isn’t much research on the direct benefits of yoga for PAH, its slow and mindful stretching reduces stress and lowers inflammation in your body.
Light resistance training. You can keep your muscles flexible and strong by using light weights (soup cans can work well) or just bodyweight. A rehab specialist can teach you movements like chair squats, wall push-ups, calf raises, bicep curls, and more.
It’s important not to lift heavy weights, as this can make symptoms worse.
“If you exert yourself and do more high-intensity weightlifting, there’s a chance you’re putting more stress on the right side of the heart, depending on the cause of pulmonary hypertension,” says Chung.
You’re more likely to hold your breath as you lift, which increases the pressure in your chest cavity.
As with any exercise routine, watch for signs that you’ve been doing too much. Keep these safety tips in mind:
Tell your doctor about any side effects that you are concerned about, such as swelling or shortness of breath more than usual.