Cardiovascular rehabilitation is one of the most important pillars for the recovery of people with coronary artery disease. Among the various types of exercise recommended for these patients, swimming and other water activities have gained prominence due to their consistent results and the safety they offer. A recent study reinforces this evidence by analyzing how training in water impacts heart rate variability, an essential indicator of heart health.
In patients with coronary artery disease, heart rate variability (HRV) functions as a thermometer of the balance between the sympathetic and parasympathetic nervous systems. The greater this variability, the better the heart’s ability to respond to stress, recover and maintain stability. A low HRV is associated with a higher risk of cardiac events and lower adaptive capacity.
The science behind aquatic exercise
The study analyzed compared exercise programs performed in water and on land in patients who had recently experienced a coronary event. The researchers evaluated participants for 14 days, monitoring a range of physiological markers, with a special focus on heart rate variability. The results are encouraging: aquatic training was not only safe, but also promoted positive and specific changes in HRV.
This is because the aquatic environment offers additional benefits to the cardiovascular system. The hydrostatic pressure of the water improves venous return, reduces joint overload and aids circulation, allowing patients to perform movements with greater comfort and less risk. Furthermore, water provides constant resistance, which stimulates the muscles in a balanced way and contributes to overall strengthening.
An important aspect of the research is that it represents the largest study ever conducted comparing aquatic and land-based exercise in people with recent coronary artery disease, which adds more robustness to the scientific evidence available to date.
Safe and supervised rehabilitation: where water makes a difference
For heart patients, physical activity should only be performed with professional guidance. Cardiopulmonary rehabilitation involves monitoring by a doctor, a physiotherapy team and trained professionals to monitor the body’s response. In aquatic environments, this supervision remains essential, but the risk of muscle and joint overload tends to be lower, which increases the safety of the process.
Swimming and water aerobics have positive effects on both physical and emotional conditioning. Many patients report improved mood, reduced symptoms such as shortness of breath and palpitations and increased confidence when realizing that they can perform exercises comfortably.
Aquatic rehabilitation programs also promote adherence, as water provides a feeling of lightness and well-being, reducing discomfort and encouraging the continuation of sessions.
Taking care of your heart is a daily movement
The combination of science, adequate supervision and regularity makes aquatic activity an excellent ally for those living with coronary artery disease. By improving heart rate variability, these exercises contribute to the stability of the cardiovascular system and enhance the body’s ability to respond to stress and recover.
The message is clear: exercise is safe and beneficial for these patients, especially when it is part of a structured rehabilitation program. Whether in water or on land, the most important thing is to have professional guidance and remain committed to regular practice. Taking care of your heart is an ongoing process – and aquatic rehabilitation can be a decisive step on that journey.
Dr. Manuela Gomes de Aguiar – CRM-SP 211.590 RQE 6275
Cardiologist
Rhythmology and Pacemaker Specialist
Membro da Brazil Health
