2020 Sports Cardiology and Exercise in Cardiovascular Patients Guidelines

Moderate physical activity is necessary and safe for people with cardiovascular (CV) conditions, according to the first sports and exercise guidelines released by the European Society of Cardiology. Clinicians should encourage people with heart disease to exercise moderately most days so that they accumulate at least 150 minutes of exercise per week. Those who are obese, diabetic, or have high blood pressure may benefit most from strength-building exercise such as lifting weights at least 3 times a week, plus moderate or vigorous aerobic exercise. Endurance sports and competitive athletes may require special monitoring and modifications.

Prof. Antonio Pelliccia (Institute of Sports Medicine and Science, Italy) presented the new ESC Guidelines, which will be the benchmark recommendations for future guidelines [1]. The guidelines have included the most current research in exercise in patients with CV disease. Where possible, these new guidelines align with existing ESC Guidelines for the investigation, risk assessment, and management of individuals with cardiovascular diseases to promote exercise programmes and sports participation.

In the first sections, evidence is weighed regarding recreation and competitive sports in the general population, with estimated incidences of CV death in both younger and older athletes with no history of health problems or putative congenital heart syndromes.

The bulk of the guidelines examine evidence of exercise in the clinical setting in patients with CV diseases. The chance of exercise triggering cardiac arrest or heart attack is extremely low, but clinicians should aim to monitor activity intensity and suggest modifications when needed. Special attention is also given to data supporting recommendations for individuals with obesity, hypertension, dyslipidaemia, or diabetes. Importantly, an entire concluding chapter is dedicated to gaps in existing evidence, which may serve as hypothesis-generating for future research.

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   1. Pelliccia A, et al. 2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease. 2020 New ESC Guidelines, ESC Congress 2020, 31 Aug.
   2. Pelliccia A, et al. Eur Heart J. 2020;ehaa605. DOI:10.1093/eurheartj/ehaa605/5898937.