This leaflet answers common questions about exercise for patients with pulmonary arterial hypertension (PAH). If you would like further information, or have any particular worries concerning your exercise routine please do not hesitate to ask your specialist centre. 

 Thanks to research, over time it has become clearer that exercise is not only safe but beneficial in patients with PAH. Current guidelines recommend that PAH patients should be encouraged to be active within symptom limits. 

Exercise can stop and reverse the deconditioning that comes with having a chronic condition such as PAH. It can also optimise the benefits derived from target therapy. 

What can exercise do for me? 

If you have PAH you may think you cannot exercise as it makes you breathless, however, it is absolutely normal to feel this way. It is important to make time for physical activity as the more you do, the more you will be able to do. It is often one of the things we do not prioritise and therefore it is important to schedule time for it. 

Benefits may include: 

  • Improve your quality of life, your frame of mind and help you to lose weight. 
  • Being in better shape will help you to manage your PAH better. 
  • Regular exercise can help you to improve your confidence. 
  • Regular exercise can even help you to rediscover things that you thought you could no longer do or help you do the same things while feeling less breathless. 
  • Exercise is also a great way to relieve stress.  

What not to expect from exercise 

  • Exercise itself cannot reverse your pulmonary arterial hypertension or change the disease in your body 
  • You should not expect immediate results. Staying active is something that you need to incorporate into your daily life 

How much should I exercise? 

Public Health England recommends that adults should take part in at least 150 minutes of moderate intensity physical activity each week. 

The amount of exercise you should do will depend on how much you currently do. It is important that you adjust your goals to accommodate your current level of fitness. When planning your exercise, consider the below: 

  • If you already go to a gym 
  • How active you are in your daily routine 
  • If you are sedentary for most of the day 

It is all about building up your exercise tolerance. 

What counts as moderate physical activity 

  • Walking 
  • Gardening 
  • Hiking 
  • Dancing 
  • Cycling 
  • Swimming 
  • Active recreation 

What type of exercise should I do? 

  • Low level aerobic exercise can be beneficial 
  • Aerobic exercise includes activities such as walking, swimming or cycling 
  • You can walk down your street and back, increasing the walk a little at a time. Alternatively, plan a route that would accommodate your level of fitness 
  • You could include low impact exercise such as yoga and in time, you may be able to build up to more intense exercises 
  • If you sign up for any exercise classes, always tell your instructor about your condition 

Exercising at the right level for me 

You should be able to talk while exercising. If breathing is too hard it means you need to slow down; you can do this by using the talk test. 

The talk test

Say out loud: “This activity is going to do me good!” 

  • If you can say the sentence with two or three stops for breath, you’re working at a moderate intensity. This is your aim 
  • If you can say the whole sentence without stopping, you can increase the intensity 
  • If you can’t speak, or can’t say more than one word at a time, you may want to slow down 

(British Lung Foundation, 2017) 

You should stop exercising if: 

  • If you feel exhausted, light headed or dizzy 
  • If you have any chest pain or discomfort 
  • If you are experiencing severe breathless