Background: Pulmonary hypertension (PH) is a potentially life-threatening condition with
an increased global awareness. Although PH can be long-time asymptomatic in the early stages, it
may participate in cardiac remodelling, leading to heart failure and death. Generally, physical exercise
is not recommended for safety concerns, but nowadays, evidences in scientific literature are proving
its efficacy as complementary treatment in PH.
Methods: An increasing number of studies are focusing on how exercise can improve the
cardiopulmonary function and the quality of life overall. We briefly examined and summarized the
benefit of exercise training in patients with PH, analyzing the evidence-based recommendations about
exercise training in these patients.
Results: Throughout the analysis of the physiological mechanisms that may be the basis for the
amelioration of the symptoms and provided evidence-based recommendations about frequency, type,
intensity and setting of exercise training, we consistently verified that increasing physical activity
could help to better manage the pulmonary hypertension.
Conclusion: An exponential number of studies show the potential role of exercise as additional
treatment in PH, with significant effects in several clinical and haemodynamic parameters as
endurance, peak oxygen consumption, cardiovascular, respiratory and musculo-skeletal function. In
terms of activity of daily living, the improvement in 6-minute walking distance is similar to that
achieved with optimal use of medication. Longer and larger studies are needed to determine whether
exercise training benefits on exercise capacity, cardiorespiratory fitness and quality of life are
maintained in the long-term and also include an improvement in clinical outcomes.