By Gillian Cardiovascular disease (CVD) remains one of the leading causes of death and disability in Australia, with lifestyle factors—particularly physical inactivity—playing a significant role in its development and progression. In response to this, exercise physiology has emerged as a cornerstone of both prevention and recovery strategies for heart disease, offering scientifically guided, individualised programs that promote long-term cardiovascular health.
Exercise physiology bridges the gap between clinical care and physical activity. It provides structured and safe exercise interventions for individuals with chronic diseases, including those at risk of, or recovering from, cardiac events. The growing recognition of its impact has led to its integration into national healthcare models, where Accredited Exercise Physiologists (AEPs) collaborate with medical professionals to deliver tailored rehabilitation and prevention solutions.
With a clear emphasis on evidence-based practice, exercise physiology not only reduces the risk of future cardiac episodes but also improves overall quality of life, mental well-being, and physical independence.
Understanding Heart Disease and Its Risk Factors
Heart disease is a term that encompasses various cardiovascular conditions, including coronary artery disease, heart failure, arrhythmias, and congenital heart defects. The most common form, coronary artery disease, occurs when the coronary arteries become narrowed or blocked due to the buildup of plaque, leading to reduced blood flow to the heart muscle.
Primary risk factors include:
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High blood pressure (hypertension)
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High cholesterol
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Type 2 diabetes
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Obesity
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Smoking
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Sedentary lifestyle
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Poor dietary habits
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Excessive alcohol consumption
While genetics and age also play a role, many of these risk factors are modifiable through lifestyle interventions—chief among them being regular physical activity.
The Role of Exercise in Heart Health
Exercise plays a critical role in maintaining and improving cardiovascular health. It strengthens the heart muscle, improves circulation, lowers blood pressure, and helps regulate cholesterol and blood sugar levels. Additionally, exercise enhances endothelial function, reduces inflammation, and promotes healthy weight management—all vital components in the prevention and management of heart disease.
There are three primary exercise types beneficial for heart health:
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Aerobic exercise – such as walking, swimming, or cycling – improves cardiovascular endurance and reduces cardiac workload.
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Resistance training – involving weights or bodyweight exercises – supports muscle strength and metabolic efficiency.
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Flexibility and balance training – such as stretching and tai chi – enhance mobility and reduce injury risk, especially in older adults.
Exercise physiology ensures these activities are adapted to suit individual capabilities, medical histories, and goals.
Prevention Through Exercise Physiology
For individuals at risk of developing heart disease, early intervention through an exercise physiology program can significantly reduce risk factors and delay the onset of cardiovascular issues. A personalised approach is particularly beneficial for those with comorbidities such as type 2 diabetes or obesity, where exercise must be carefully planned and monitored.
Preventative strategies include:
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Comprehensive health and fitness assessments
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Prescription of safe, achievable exercise programs
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Behavioural support and education on physical activity adherence
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Monitoring of cardiovascular responses to exercise
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Ongoing re-evaluation to track improvements and adjust goals
Participation in supervised physical activity also increases accountability and motivation, which are key to sustaining long-term behavioural change.
Initiatives like RedoHealth’s article on group exercise classes highlight how structured group-based programs, often led by exercise professionals, can offer both social support and clinical oversight. This model has proven especially effective for at-risk populations seeking to integrate movement into their daily lives.
Recovery After Cardiac Events
For those recovering from heart attacks, surgeries, or other cardiac events, a structured exercise rehabilitation program is essential for physical and psychological recovery. Exercise physiology is a key component of cardiac rehabilitation, typically delivered in phases:
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Inpatient rehabilitation (Phase 1): Begins in hospital, focusing on mobility and early recovery.
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Outpatient supervised rehabilitation (Phase 2): Conducted in clinical or community settings, focusing on functional capacity building.
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Maintenance phase (Phase 3): Involves unsupervised but guided home-based or group exercises to encourage independence and lifestyle change.
AEPs work closely with cardiologists and general practitioners to ensure safety and optimise recovery outcomes. They monitor vital signs, adjust exercise intensity, and identify any adverse responses to physical activity. Beyond physical improvements, exercise rehabilitation addresses post-event anxiety, depression, and fear of re-injury, fostering confidence and autonomy.
Benefits of post-cardiac rehabilitation include:
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Improved heart function and exercise tolerance
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Reduction in symptoms such as breathlessness and fatigue
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Lowered hospital readmission rates
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Enhanced emotional well-being
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Improved medication compliance
Individualised Programs for Diverse Needs
Exercise physiology is not a one-size-fits-all solution. Each program is designed after a thorough evaluation of:
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Medical and surgical history
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Medications and potential interactions
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Physical limitations
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Functional fitness levels
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Personal goals and preferences
For older adults or those with mobility issues, low-impact exercises with careful supervision can build strength without strain. For younger individuals with early signs of cardiovascular risk, more intensive lifestyle interventions may be appropriate.
This individualised approach also accounts for cultural, psychological, and environmental factors that may influence a person’s ability to engage with physical activity. Flexibility and ongoing support make adherence more likely and outcomes more effective.
The Role of Behavioural Change in Long-Term Success
A key strength of exercise physiology lies in its focus on sustainable change. Behavioural strategies used by AEPs help patients overcome common barriers to exercise such as:
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Lack of time or motivation
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Fear of exacerbating symptoms
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Confusion over what constitutes “safe” activity
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Negative previous experiences with exercise
Techniques include motivational interviewing, goal setting, self-monitoring, and problem-solving. These are often integrated with technology such as wearable fitness trackers or digital health apps to reinforce daily habits.
Education is also a critical component. Patients are taught to recognise warning signs during activity, understand the impact of exercise on their condition, and feel empowered to make informed choices.
Complementary Lifestyle Interventions
While exercise physiology is a key component of cardiovascular care, it is most effective when paired with other lifestyle modifications:
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Nutrition: Diets rich in fruits, vegetables, lean proteins, and whole grains reduce cholesterol and support weight management.
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Smoking cessation: AEPs can refer patients to programs designed to help them quit smoking, a major contributor to heart disease.
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Stress management: Techniques such as mindfulness, breathing exercises, and yoga help manage emotional triggers that may affect heart health.
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Sleep hygiene: Encouraging consistent, high-quality sleep supports overall recovery and reduces cardiac stress.
AEPs often work within multidisciplinary teams, ensuring coordinated care that addresses every aspect of heart disease prevention and recovery.
Government and Community Support in Australia
In Australia, exercise physiology services are recognised and supported under Medicare for individuals with chronic conditions through the Chronic Disease Management (CDM) program. This support enables eligible patients to access a limited number of sessions with an AEP, often referred by a GP.
In addition to Medicare, private health insurance providers and workers’ compensation schemes may offer rebates for exercise physiology services, recognising their clinical value.
Community programs, especially those delivered in regional or underserved areas, have also played a pivotal role in broadening access to cardiovascular rehabilitation. These programs often include culturally appropriate services for Aboriginal and Torres Strait Islander communities, who face a higher burden of heart disease.
The Evidence Behind the Practice
The benefits of exercise for cardiovascular health are supported by a large body of scientific evidence. Studies consistently demonstrate that regular, moderate-to-vigorous physical activity:
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Reduces all-cause and cardiovascular mortality
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Improves lipid profiles and glucose metabolism
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Enhances quality of life
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Decreases risk of hospitalisation
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Reduces inflammation markers associated with atherosclerosis
Furthermore, cardiac rehabilitation programs incorporating exercise physiology have been shown to reduce the risk of recurrent events and mortality by up to 30%, making them a vital part of post-cardiac care pathways.
Exercise physiology is a powerful tool in both preventing and managing heart disease. By delivering personalised, evidence-based exercise interventions, AEPs empower individuals to take control of their cardiovascular health—whether aiming to prevent a first event or recover from a major cardiac episode.
Through close collaboration with healthcare teams, targeted exercise prescription, and a strong emphasis on education and behavioural support, exercise physiology plays an indispensable role in reducing the burden of heart disease in Australia. Its integration into community health models and national guidelines highlights its growing relevance in modern preventative medicine.
As heart disease continues to challenge public health systems, exercise physiology offers a path forward—one grounded in movement, empowerment, and measurable outcomes.
