Strength Training with Heart Disease: Safe, Effective, and Backed by Science

If you or a loved one has heart disease, chances are you’ve been told to “take it easy.” While it’s important to be cautious, that advice often leads to unnecessary inactivity. The truth? Strength training can be a powerful tool in managing and improving heart health—when done safely and properly.

Let’s break down what the science says and how you can start reaping the benefits without risking your health.

Why Strength Training Matters for Heart Health

Historically, aerobic exercise (like walking or cycling) has taken centre stage in cardiac rehabilitation. But more recent research shows that resistance training—also called strength or weight training—is equally important.

According to the American Heart Association (AHA) and Canadian Association of Cardiovascular Prevention and Rehabilitation (CACPR):

• Strength training improves muscular endurance, strength, and physical function

• It lowers resting blood pressure, improves insulin sensitivity, and supports healthier lipid profiles

• It can reduce the workload on the heart during daily activities by making your muscles more efficient

In fact, the AHA’s 2021 scientific statement encourages resistance training for patients with stable heart disease, including those with:

• Coronary artery disease (CAD)

• Congestive heart failure (CHF)

• Post-cardiac surgery

• Hypertension

• Heart valve disease

Reference: Williams MA, et al. Resistance Exercise in Individuals With and Without Cardiovascular Disease: 2007 Update. Circulation. 2007;116:572–584.

Is Strength Training Safe for People with Heart Disease?

Yes—but with some important considerations.

The key is to start slow, progress gradually, and work with a qualified professional like a Clinical Exercise Physiologist. Most adverse events related to resistance training occur when people do too much too soon, lift weights that spike their blood pressure, or fail adapt their program to take into account their cardiac diagnosis and mediations,

Safety Tips:

• Begin with 2 days/week, working major muscle groups

• Start with light weights or resistance bands

• Avoid holding your breath during exertion (no Valsalva maneuver)

• Initially aim for 12-15 repetitions per set to keep the weight moderate

• Monitor for signs of overexertion: dizziness, chest discomfort, shortness of breath.  Keep in mid that many blood pressure lowering medications can predispose you to dizziness especially with rapid postural changes or lifting overhead

• If recovering from open heart surgery, activities that load and/or retract the chest wall should be avoided if any chest wall discomfort is still present with daily activities or reproduced with resistance training.

The Benefits Go Beyond the Heart

Strength training doesn’t just improve heart health. It also helps with:

• Maintaining independence in daily life

• Preventing falls by improving balance and muscle control

• Reducing depressive symptoms often associated with chronic illness

• Supporting bone density and joint health, especially for older adults

When paired with aerobic activity, it creates a comprehensive plan for long-term health, energy, and resilience.

Research by McCartney and McKelvie (1998) highlights that properly supervised resistance training is both safe and beneficial for individuals with stable cardiac conditions. In their review, they emphasize that resistance training improves muscular strength, endurance, and functional capacity, which are all critical in promoting independence and quality of life in cardiac patients. Importantly, their findings support that, when combined with aerobic exercise and prescribed with appropriate intensity and progression, resistance training does not increase the risk of adverse cardiac events. Instead, it may reduce cardiac workload during daily activities by enhancing muscular efficiency, especially in the upper body, where deconditioning is common post-surgery

Weightlifting After Open-Heart Surgery: A Safe and Structured Approach

Recovering from open-heart surgery, including procedures like coronary artery bypass grafting (CABG) or valve replacement, involves careful attention to sternal healing. The sternum, which is divided during surgery, typically requires about 8 to 12 weeks to heal adequately. During this period, it’s crucial to follow specific precautions to ensure proper healing and avoid complications.

Weeks 1–6: Prioritize Healing and Gentle Movement

• Lifting Restrictions: Avoid lifting more than 5 to 10 pounds to prevent undue stress on the healing sternum.

• Movement Guidelines: Refrain from pushing, pulling, or lifting objects overhead. Keep upper arm movements within a comfortable range and close to the body.

• Exercise Focus: Engage in gentle lower-body exercises, such as walking or seated leg extensions, to maintain circulation without compromising sternal integrity.

Weeks 6–12: Gradual Reintroduction of Upper Body Activity

• Light Resistance Training: Begin with light resistance exercises, like bicep curls or wall push-ups, using minimal weight (e.g., 1–2 pounds).

• Symmetrical Movements: Use both arms simultaneously to ensure even distribution of force across the sternum.

• Monitoring: Pay close attention to any signs of discomfort, clicking, or instability in the chest area.  If any of these occur discontinue upper extremity activity and consult your healthcare provider.

Post 12 Weeks: Progression to Pre-Surgical Activities

• Increased Resistance: With medical clearance, gradually increase resistance training intensity, focusing on controlled movements and proper form.

• Functional Exercises: Incorporate exercises that mimic daily activities or specific goals, such as returning to sports or hobbies.

• Continued Caution: Even as strength and endurance improve, remain vigilant for any unusual symptoms and maintain regular follow-ups with your healthcare team.

Note: Individual recovery timelines can vary based on factors like age, overall health, and the presence of co-morbidities. Always consult with your healthcare provider before initiating or progressing your exercise regimen.

Need Help Getting Started?

Strength training is not only safe for most people with heart disease—it’s one of the best ways to improve quality of life, regain confidence, and protect your health long-term.

If you’re unsure how to begin—or nervous about doing it safely—we can help.

At The Online Exercise Clinic, we specialize in virtual, evidence-based exercise programming for people living with chronic diseases and disabilities. Whether you’re managing heart disease, recovering from a cardiac event, or just want expert guidance you don’t have to go it alone.  Let us create a personalized, heart-smart strength plan for you.

Let’s get you moving—stronger, safer, and smarter.

The information in the blog is provided for informational and educational purposes only and does not constitute medical advice.  The information is not a substitute for professional medical advice, diagnosis, or treatment.  For questions please follow up with your healthcare professional.