Exercise for cardiac rehabilitation


As I’ve written in previous blogs (click here), coronary heart disease is the biggest killer in the UK.  Not only that, there are 2.3 million people in the UK, who are living with coronary heart disease, including 500,000 who have been diagnosed with heart failure.

Whether these 2.3 million people have had a cardiac emergency, such as a heart attack, or they have had a diagnosis of a cardiac condition like angina, rehabilitation and recovery can be a daunting prospect.  This is why it is so important for cardiac patients to work with a qualified cardiac rehabilitation exercise instructor.

The cardiac rehabilitation exercise instructor

I have been qualified as a cardiac rehabilitation exercise instructor since 2020, and recently renewed my qualification for another three years.  Of all of the qualifications that I have done, this is the most professional and the most thorough.  It has given me an in-depth understanding of:

  • Cardiovascular anatomy and physiology
  • The development, diagnosis, and treatment of coronary heart disease
  • The medications prescribed to cardiac patients and their side effects
  • How to plan a safe and effective exercise sessions for cardiac patients

To further my understanding of cardiac rehabilitation following my training I have worked in the NHS phase 3 hospital-based cardiac rehab programme and also led a community-based phase 4 exercise class for 18 months.  

I now only work with private clients on their cardiac rehabilitation, as I feel that this is the most effective approach, and it is the one which I find most rewarding because of the depth of the relationship that develops between the client and myself. Here are a couple of quotes from clients that I have worked with in the past 12 months:

I started training with Neil as part of my cardiac rehabilitation after a heart attack. In addition to providing exercises especially for cardiac rehabilitation, he tailored my training programme to my specific needs week by week.” David

Neil is a great coach. He’s very knowledgeable and very supportive and the most calm person I’ve ever met. His experience with cardiac rehab has been invaluable and so reassuring for me following my attack.” Dee

The aim of a cardiac rehab exercise programme is to build cardiovascular fitness.

Cardiac rehabilitation exercise specifics

The purpose of a cardiac rehabilitation exercise programme is to train clients to exercise safely, effectively, and regularly so that they improve their aerobic functional capacity, which will reduce their risk of having another cardiac event.

One of the first elements of the program to get right is the warm up. Cardiac patients should do a progressive warm up of at least 15 minutes to give the coronary arteries the time to expand before more strenuous exercise is undertaken in the main part of the session.  This maximises oxygen supply to the heart muscle.

The main part of the session is 20-30 minutes of cardiovascular conditioning, which can be done as continuous training or interval training. I usually choose to do interval training with my clients with the cardiovascular exercises, such as squats, interspersed with active recovery exercises, such as bicep curls.  The exercise intensity is set at 40 to 70% of heart rate reserve, which I calculate based on the client’s age, resting heart rate, and whether or not they have been prescribed beta blockers.  I then monitor the client’s heart rate throughout the session using a Wahoo heart rate monitor.

At the end of the session, the client is taken through a 10 minute period of cooldown activities. These exercises are designed to reduce the heart rate steadily to avoid any chance of atrial fibrillation, and/or postural hypotension.

Interval training with some weightlifting is a good way to build overall fitness.


Anyone who has had a heart attack, or a coronary heart disease diagnosis should exercise regularly in their recovery with a qualified cardiac rehabilitation exercise instructor such as myself. This will ensure that they are able to exercise safely and effectively.  If you, or a friend or family member, need support to exercise effectively in cardiac rehabilitation then please get in touch by clicking Contact in the menu at the top of this page.  

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