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Is exercise safe if you have hypertrophic cardiomyopathy?

Many people with HCM restrict exercise because of the risk of complications, but inactivity carries its own risks.

While some forms of activity may need to be limited or avoided, a person with HCM will not want to avoid physical activity altogether.

Physical activity is an essential part of a healthy lifestyle. But for people living with hypertrophic cardiomyopathy (HCM), exercise is sometimes discouraged because it may put too much strain on the heart and increase the risk of serious complications, including sudden cardiac death. At the same time, inactivity also increases the risk of serious health problems.

If you are living with HCM and questioning whether to exercise and how much to exercise, here’s a guide to help you get started.

You need to talk to your healthcare provider

Before going any further on this topic, understand that HCM is a different experience for every person. It affects people of all ages—there are people diagnosed in childhood, people diagnosed in their 90s, and people diagnosed at all ages in between.

Your healthcare provider will be your best source of information about your diagnosis, the health of your heart, and guidelines for exercise. HCM should be treated by a cardiologist—and ideally, a cardiologist who has significant experience treating HCM.

How does HCM affect the heart?

HCM is caused by genetic mutations that affect the muscle tissues in the heart. When a person has HCM, muscle tissue in the heart becomes thickened. As a result, the heart pumps less blood and pumps blood less effectively. The heart may also require more oxygen and energy to function normally, especially during any form of physical exertion.

What is sudden cardiac death?

Sudden cardiac death can occur when the heart can no longer beat effectively enough to keep a person alive. This is a rare complication of HCM, but it does occur. It is much more common in young athletes who are undiagnosed and untreated.

What does vigorous exercise mean?

If you are searching for information about HCM and exercise, you will come across terms like very strenuous activity, vigorous activity, and intense exertion. It’s important to know that these terms can mean different things to different people—what might be safe for one person with HCM may not be safe for another person. Again, your healthcare provider can help you determine what these terms mean for you.

Inactivity is harmful to your health

While some forms of activity may need to be limited or avoided, a person with HCM will not want to avoid physical activity altogether. Sedentary lifestyle—little or no physical activity—is one of the most significant risk factors for poor health.

Inactivity is associated with a higher risk of obesity, type 2 diabetes, high blood pressure, heart attack, stroke, certain cancers, and increased depression and anxiety. Any of these conditions can occur alongside HCM. Some health conditions—including obesity, high blood pressure, and type 2 diabetes—have been associated with a greater risk of complications in people who are living with HCM.

Staying active can benefit your health

In the past, many people with HCM have been discouraged from exercise due to the risk of complications like sudden cardiac death. Studies in recent years have recommended revising exercise restrictions for HCM, pointing to the benefits that staying active can have for physical and mental health, which are important elements of care for people with HCM.

Again, it’s not recommended to begin or change an exercise routine without consulting your healthcare providers. The risk of complications from HCM varies from person to person, and your healthcare provider can assess your risk and determine guidelines for how to exercise and how much to exercise.

Article sources open article sources

Yuen W Liao, James Redfern, et al. Hypertrophic cardiomyopathy and exercise restrictions: time to let the shackles off? The British Journal of Cardiology, 2020. Vol. 27, No. 1.
MedlinePlus. Health Risks of an Inactive Lifestyle.
Hypertrophic Cardiomyopathy Association. Why Does Hypertrophic Cardiomyopathy Develop?
Haley Otman. Exercising with Hypertrophic Cardiomyopathy: I Want to Be Fit and Strong. Michigan Medicine. February 21, 2022.
NYU Langone Health. Lifestyle Changes for Hypertrophic Cardiomyopathy.
Centers for Disease Control and Prevention. Hypertrophic Cardiomyopathy (HCM) and Family Health History of Sudden Death.
Allison G. Yow, Venkat Rajasurya, and Sandeep Sharma. Sudden Cardiac Death. StatPearls. August 8, 2022.
Gourg A. Atteya, Sharlene M. Day, and Rachel J. Lampert. Sports and Exercise in Patients with Hypertrophic Cardiomyopathy: More Questions than Answers. American College of Cardiology. February 23, 2017.
Adaya Weissler Snir, Kim A. Connelly, et al. Exercise in hypertrophic cardiomyopathy: restrict or rethink. American Journal of Physiology: Heart and Circulatory Physiology, 2021. Vol. 320, N. 5.
Yuen W Liao, James Redfern, et al. Hypertrophic cardiomyopathy and exercise restrictions: time to let the shackles off? The British Journal of Cardiology, 2020. Vol. 27, No. 11.
Rachel Lampert, Michael J. Ackerman, and Bradley S. Marino. Vigorous Exercise in Patients With Hypertrophic Cardiomyopathy. JAMA Cardiology, 2023. Vol. 8, No. 6.
Joyee Basu, Aneil Malhotra, and Michael Papadakis. Exercise and hypertrophic cardiomyopathy: Two incompatible entities? Clinical Cardiology, 2020. Vol. 43, No. 8.
Ying Hong, Wilber W. Su, and Xiaoping Li. Risk factors of sudden cardiac death in hypertrophic cardiomyopathy. Current Opinion in Cardiology, 2022. Vol. 37, No. 1.

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