Physical activity encouraged for adults and children with congenital heart disease

Issue: July 2013

A new scientific statement from the American Heart Association focuses on the importance of regular physical activity in adults and children with congenital heart disease.

“Counseling of patients with congenital heart defects should emphasize the importance of daily physical activity and decreasing sedentary behavior as appropriate for the patient’s clinical status,” according to the statement.

The statement defines physical activity as all types of physical movement and defines exercise as planned repetitive physical activity designed to improve fitness.

“There is no evidence regarding whether or not there is a need to restrict recreational physical activity among patients with congenital heart defects, apart from those with rhythm disorders. It is important to recognize that most patients with congenital heart defects are relatively sedentary and that the physical and psychosocial health benefits of physical activity are important for this population, which is at risk for exercise intolerance, obesity and psychosocial morbidities,” the authors wrote.

Recommendations for physical activity

Healthy adults are encouraged to engage in muscle-building activities two or more times per week and 75 to 150 minutes of moderate to vigorous activity lasting a minimum of 10 minutes per session.

Children are recommended to engage in at least 60 minutes of daily physical activity, muscle- and bone-strengthening activities at least 3 days per week and periods of vigorous activity at least 3 days per week.

“Counseling to encourage daily participation in appropriate physical activity should be a core component of every patient encounter,” the authors wrote in the statement.The recommendations for physical activity promotion are based on general recommendations for physical activity for healthy children and adults because only a limited amount of research on physical activity among congenital heart disease patients has been conducted.

In addition, screen time via the TV, computer or iPad is discouraged, and the statement includes a recommendation for no more than 2 hours daily for children aged 5 years and older and no screen time for children aged younger than 3 years.

Future research

Given the high rate of survival for patients with congenital heart disease living into adulthood, knowing the risk factors for acquired heart disease are becoming increasingly important. The lack of relevant research-specific physical activity evidence among individuals with congenital heart disease is a call for action to recommend more research in these areas, according to the statement.

Optimal dose, duration and intensity of physical activity for improving health outcomes in children and adults with congenital heart disease.
Strategies for increasing and improving the knowledge and awareness of physical activity among congenital heart disease patients and family members.
Longitudinal studies examining growth, development and health benefits for patients with congenital heart disease.
Optimal mediums for promoting physical activity in this population (eg, counseling and e-health).
Evaluation of physical activity counseling and referral strategies with an emphasis on cost and quality outcomes.
Optimal methods for assessing and monitoring adverse responses to physical activity in adults and children with congenital heart disease.
Evaluation of adverse physical and psychosocial health consequences of a sedentary lifestyle in children and adults with congenital heart disease.

For more information:

Longmuir PE. Circulation. 2013;doi:10.1161/CIR.0b013e318293688f.

Disclosure: One author reports consulting for the National Childhood Obesity Foundation. All other authors report no relevant financial disclosures.