Note from the National Guideline Clearinghouse: The recommendations that follow are from the guideline's "Summary of Evidence and Recommendations"; detailed recommendations can be found in the original guideline document.
The levels of evidence (I, II, III-1, III-2, III-3, IV) and grades of recommendations (A-D) are defined at the end of the "Major Recommendations" field.
The National Heart Foundation of Australia recommends that to benefit health, people with cardiovascular disease (CVD) should aim, over time, to include 30 minutes or more of moderate-intensity physical activity on most, if not all days of the week. The amount of activity can be accumulated in short bouts; such as three 10-minute sessions each day. A person's current level of activity, the severity of their cardiovascular condition, co-morbidities, and personal preferences should determine the approach and rate of progress towards these goals.
| Evidence |
Level of Evidence |
Recommendations |
Grade |
| Brief physical activity advice from primary carers is effective in increasing levels of physical activity. |
II |
Doctors and clinicians should routinely provide brief, appropriate, written physical activity advice to patients with well-compensated clinically stable CVD. |
B |
| Exercise rehabilitation soon after an acute coronary syndrome (ACS) event or coronary revascularisation is effective in accelerating functional capacity and lowering subsequent risk for cardiovascular events. |
I |
Well-compensated, clinically stable recent (<2/52) survivors of a myocardial infarction (MI), unstable angina pectoris (UAP), coronary artery bypass grafting (CABG), or percutaneous coronary interventions (PCI), should be offered and, where available, participate in a short period (up to 12 weeks) of supervised exercise rehabilitation. |
A |
| Habitually physically active older men with CVD have a lower risk of all-cause and cardiovascular mortality. |
III-2 |
Well-compensated, clinically stable people with CVD should progress over time to 30 minutes (all together or in shorter bouts), or more, of up to moderate intensity physical activity on most, if not all days of the week. Those with advanced CVD may have to down regulate the recommended dose. |
B |
| Regular physical activity increases the functional capacity of people with heart failure. |
I |
Well-compensated, clinically stable people with heart failure should progress over time to 30 minutes (all together or in shorter bouts), or more, of up to moderate intensity physical activity on most, if not all, days of the week. |
A |
| Regular physical activity increases the functional capacity of people with implantable cardiac devices, congenital or valvular heart disease. |
IV |
Well-compensated, clinically stable people with valvular heart disease, congenital heart disease, or implantable cardiac devices should progress, over time, to 30 minutes (all together or in shorter bouts), or more, of up to moderate intensity physical activity on most, if not all days of the week. |
D |
| Older habitually physically active people with CVD show improved functional capacity and mental wellbeing. |
II |
Unless contraindicated, all older people with CVD should progress, over time, to 30 minutes (all together or in shorter bouts), or more, of moderate intensity physical activity on most, if not all days of the week. |
B |
| Regular physical activity improves functional capacity among people with stroke, peripheral vascular disease (PVD), or diabetes. |
II |
Unless contraindicated, all people with PVD, diabetes, and stroke survivors with sufficient residual function should progress over time to 30 minutes (all together or in shorter bouts), or more, of up to moderate intensity physical activity on most, if not all days of the week. |
B |
| Prescriptive light to moderate resistance activity is safe and improves muscle fitness among people with CVD. |
II |
Well-compensated, clinically stable people with CVD should initiate resistance activity under supervision by a trained health professional. |
B |
Definitions:
Levels of Evidence
I: Evidence obtained from a systematic review of all relevant randomized controlled trials (RCTs).
II: Evidence obtained from at least one properly designed randomised controlled trial.
III-1: Evidence obtained from well-designed pseudo-randomised controlled trials (alternate allocation or some other method).
III-2: Evidence obtained from comparative studies with concurrent controls and allocation not randomised (cohort studies), case-control studies, or interrupted time series without a control group.
III-3: Evidence obtained from comparative studies with historical control, two or more single-arm studies, or interrupted time series with a parallel control group.
IV: Evidence obtained from case series, either post-test or pre-test and post-test.
Grades of Recommendations
- Rich body of high-quality randomized controlled trial (RCT) data (evidence level I)
- Limited body of RCT data or high-quality non-RCT data (evidence level II, III-1, III-2)
- Limited evidence (evidence level III-3, IV)
- No evidence available – panel consensus judgment
