Elaborating on previous advice, the American Heart Association (AHA) says that resistance training can help heart failure patients gain strength for day-to-day life. The new guidance -- published online in the journal Circulation -- supports using muscle strengthening exercise, such as weight lifting, as a complement to aerobic training (but not as a replacement for it).

Amit Khere, MD, director of cardiac rehabilitation at the University of Texas Southwestern Medical Center, said that this broader guidance should help to reassure both physicians and patients that it is probably OK for most people to start exercising after heart trouble, according to an In Brief wire report.

Quoted in the Wall Street Journal, AHA writing group chair Dr. Mark Williams said, "Just like we once learned that people with heart disease benefitted from aerobic exercise, we are now learning that guided, moderate weight training also has significant benefits."

Resistance training is not being recommended for patients with uncontrolled high blood pressure, uncontrolled heart rhythm disorders, unstable heart disease, or other serious heart-related conditions. Many patients, however, may receive medical clearance -- even encouragement -- to participate in the activity.

"For people with cardiovascular disease, the level of resistance should be reduced and the number of repetitions increased, resulting in a lower relative effort and reducing the likelihood of breath-holding and straining," the AHA statement advises.

Several key points from the AHA paper include these recommendations for patients beginning a resistance training program:

• Start out with a modest weight load.
• Exercise in a rhythmical manner at a slow to moderate rate of speed.
• Exhale during exertion and inhale during the relaxation phase of each weight lifting repetition.
• Alternate between upper and lower body work in order to permit sufficient rest periods between exercises.

"The emphasis at the early stage of training is to allow time for the muscles to adapt and to practice good technique, thus reducing the potential for excessive muscle soreness and injury," Williams said.