Praxis Medical Insights

Est. 2024 • Clinical Guidelines Distilled

Made possible by volunteer editors from the University of Calgary & University of Alberta

Last Updated: 8/22/2025

Guidelines for Target Heart Rate and Recommended Exercises in Cardiac Rehabilitation

Target Heart Rate Guidelines

  • The American Heart Association recommends that for supervised cardiac rehabilitation, target heart rate should be 70-85% of age-predicted maximum heart rate 1, 2
  • For unsupervised exercise, target heart rate should be 60-75% of maximum predicted heart rate 3, 4
  • Exercise intensity can also be determined using the Rating of Perceived Exertion (RPE) scale, with recommended values of 12-13 (somewhat hard/moderate) on the 6-20 scale 5
  • The American College of Cardiology recommends aerobic exercise frequency of 3-5 days per week 6
  • The American College of Cardiology recommends aerobic exercise duration of 30-60 minutes per day, which can be spread over 2-3 segments during the day 7, 8
  • Resistance training can be added 2-4 weeks after beginning aerobic training, with a frequency of 2-3 days per week 1, 2, 6

Special Considerations

  • The American Heart Association recommends that patients should be risk-stratified to determine the level of supervision and monitoring required during exercise training 6
  • Exercise is contraindicated in patients with refractory/unstable angina and other high-risk cardiovascular conditions, according to the European Society of Cardiology 9

Patient Education and Activity Guidelines

  • The American Heart Association recommends providing specific instructions on permissible and restricted activities (heavy lifting, climbing stairs, yard work, household activities) 3, 10
  • The American College of Cardiology recommends encouraging daily walking immediately after discharge 4, 7

Comprehensive Cardiac Rehabilitation Programs

  • The American Heart Association recommends that all eligible patients should be referred to a comprehensive cardiovascular rehabilitation program either before hospital discharge or during the first outpatient visit 1, 2
  • The American College of Cardiology recommends that programs should include medical evaluation, prescribed exercise, cardiac risk factor modification, education, and counseling 4, 8

REFERENCES

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