Exercise Training in High-Risk Populations: A Scientific Statement From the American Heart Association
Circulation
|July 9, 2026
Summary
Exercise programs for high-risk cardiovascular disease patients require modifications, focusing on strength and balance alongside aerobic training. These tailored interventions improve function and quality of life, despite participation barriers.
Area of Science:
- Cardiovascular Disease Research
- Exercise Physiology
- Rehabilitation Science
Background:
- Aerobic exercise training is beneficial for cardiovascular disease patients, improving fitness and reducing adverse events.
- High-risk groups (e.g., frailty, stroke, genetic cardiomyopathies, advanced therapies) need specialized exercise considerations.
Purpose of the Study:
- To summarize the current state of exercise training for high-risk cardiovascular populations.
- To identify modifications, safety protocols, and knowledge gaps in exercise interventions for these groups.
Main Methods:
- Review and synthesis of existing literature on exercise training in special cardiovascular populations.
- Analysis of functional deficits, exercise responses, and program modifications.
Main Results:
- High-risk populations face significant barriers to exercise but have low baseline fitness.
- Exercise prescriptions often need to incorporate strength, balance, and flexibility, with enhanced supervision and specialized equipment.
- Appropriately designed programs yield substantial functional and quality-of-life improvements.
Conclusions:
- Tailored exercise regimens are crucial for maximizing safety and efficacy in high-risk cardiovascular patients.
- Further research is needed to develop patient-centered, scalable, and equitable exercise therapies for diverse needs.
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