Advances in pulmonary hypertension (PH) treatments allow most people to live a relatively normal life — but what about exercise? Is it safe or recommended? Because exercise can cause shortness of breath or fatigue, it might not seem like a good idea with PH.

It might surprise you to learn that participating in regular exercise training can benefit those with PH. But it’s essential to work out safely and under your doctor’s supervision. Here’s what you should know about pulmonary hypertension and exercise before hitting the gym.

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Pulmonary Hypertension and Exercise: What Happens?

Today, exercise is a valuable addition to pulmonary hypertension therapy, but it wasn’t always that way. In the past, doctors advised against it for those with pulmonary hypertension, especially the type called pulmonary arterial hypertension (PAH).

That’s because when you exercise, blood flow increases throughout your lungs. Healthy individuals compensate for increased blood flow by sending blood to their arterioles, the tiniest branches of their pulmonary arteries.

But with PAH, arterioles in your lungs become thick and narrowed. That limits blood flow in the lungs and increases blood pressure in the pulmonary arteries. It might also bring on symptoms like shortness of breath and fatigue when you exercise.

Avoiding exercise reduces those exercise-induced symptoms, but experts now realize being sedentary comes with other risks. A lack of exercise leads to muscle wasting in other parts of your body, like your legs. That, in turn, makes it even harder to exercise, worsens your symptoms, and reduces your quality of life.

Pulmonary Hypertension Physical Exercise Recommendations

Heart and lung specialists recommend exercise for most people with PH. Regular exercise can strengthen your heart, lungs, and muscles throughout your body. It can also help reduce stress and make it easier to live with PH.

But because pulmonary hypertension affects everyone differently, it’s essential to talk to your doctor before starting any exercise program. You may need to avoid activities like weight lifting and intense cardio with pulmonary hypertension. These can put too much stress on your lungs and heart.

Instead, try these exercise safer options if you have PH:

  • Walking outside or on a treadmill.
  • Cycling on an elliptical or recumbent bike.
  • Swimming.
  • Resistance training using light weights or your body weight.
  • Gentle yoga.

Another component of pulmonary hypertension physical exercise is breathing exercises. These can strengthen your lungs and make breathing more efficient. A pulmonary rehabilitation specialist can show you how to do breathing exercises like:

  • Pursed lip breathing. You breathe in through your nose and then out through your mouth with pursed lips. Your exhale should be twice as long as your inhale.
  • Diaphragmic (belly) breathing. To do this exercise, sit or lie down and put your hands on your stomach. Inhale through your nose, mindful of letting your belly expand as though it’s filing with air. Then, exhale through pursed lips very slowly, allowing your chest and belly to fall.

These breathing exercises help keep your airways open longer, so more air can flow in and out of your lungs.

When starting a new exercise program, it’s crucial to begin under supervision. Trained cardiopulmonary rehabilitation specialists can help you design an effective program that won’t overstress your heart and lungs. They can also help you work around any physical limitations, like joint problems or portable oxygen tanks.

Safety Tips When Exercising

It’s vital to start every exercise session slowly by warming up with gentle stretches and some walking. And make sure you listen to your body while exercising because it’s easy to overdo it. These safety tips can help you ease into an exercise routine:

  • Always exercise with a partner. Or make sure there’s someone at the gym who can look out for you if you get short of breath.
  • Work out at a time of day when you have the most energy. If you don’t feel up to exercise, it’s OK to skip your workout until you feel better.
  • Make sure you eat something light before exercise and drink water during your workout.
  • Never hold your breath while working out.
  • Start with shorter, slower workouts and gradually build up.
  • If you have any adverse symptoms during or after your workout, tell your doctor.

Regular exercise is an essential part of your therapy for pulmonary hypertension. It’s one of the best ways to improve your quality of life. Getting into a regular exercise program will help you feel stronger, better, and more confident while living with this chronic disease.

American Lung Association. Breathing Exercises. Link

American Lung Association. Exercise and Lung Health. Link

About Pulmonary Hypertension

The UPMC Comprehensive Pulmonary Hypertension Program provides complete services for pulmonary hypertension (PH) and other lung diseases. We have specialists available for surgical and nonsurgical treatment of PH and related diseases like heart failure, HIV, and COPD. We have the largest multidisciplinary program in the U.S. and offer cutting-edge diagnostics and individualized treatment plans. We also are leaders in research for new treatments. Find a PH specialist near you.