Key takeaways

Patients with heart failure, including those taking Entresto, are generally recommended to exercise, but should first consult with their healthcare provider for personalized advice and potentially start with a supervised program.
Exercising while on Entresto can be safe and may improve exercise tolerance, but patients should be aware of possible side effects like low blood pressure and fatigue, and adjust their activities accordingly.
Patients taking Entresto should avoid potassium supplements and potassium-sparing diuretics, and consult their healthcare provider before using any pre-workout supplements to prevent adverse interactions.
While exercise cannot reverse heart failure, it can improve heart function and is beneficial in managing conditions that lead to heart failure, with healthcare providers recommending mild to moderate cardiovascular activities and advising patients to listen to their bodies.

Living with heart failure can be challenging, but it’s possible to live a full and vibrant life. The key is to follow guidance from your healthcare provider, adopt a healthy lifestyle, and take medication that helps your heart work optimally. One common medication that many heart failure patients are prescribed is Entresto, which is used to treat chronic heart failure. It is mainly prescribed to treat heart failure with reduced ejection fraction (when the left chamber of the heart is unable to pump blood efficiently). If you take Entresto and have noticed an improvement in your energy and stamina, you may be wondering if it’s advisable to add some exercise into your life, and if so, how to go about it.

Let’s take a look at the safety of heart failure and exercise in general and what to know about exercising if you are taking Entresto.

Can you exercise if you have congestive heart failure?

Experts recommend exercising if you have congestive heart failure, but with a few important caveats. “You can certainly exercise with heart failure,” says Giovina Lara Collura, MD, cardiologist, and assistant clinical professor of medicine and cardiology at Icahn School of Medicine, Mount Sinai. Dr. Collura explains that exercise for heart failure is associated with improved heart function, as well as general enhancement to your quality of life.

Aeshita Dwivedi, MD, a cardiologist at Lenox Hill Hospital in NYC agrees that you can safely exercise with congestive heart failure and low ejection fraction. However, she stresses the importance of consulting with your doctor before doing so.

All heart failure patients are different, so your healthcare provider will be able to give you specific advice about which exercises are right for you, and whether certain exercises are best for you to avoid. Your healthcare provider may also recommend you participate in a supervised exercise program at a cardiac rehabilitation center when you are first starting out, says Dr. Dwivedi.

Is it safe to exercise while taking Entresto?

Anytime you are considering exercising while taking medication you should consult with your healthcare provider. But in most cases, it’s safe to take Entresto and exercise. What’s more, a 2019 study found that exercise tolerance improved for people who took medications containing sacubitril and valsartan, the active ingredients in Entresto.

Dr. Collura confirms that it’s generally safe to exercise if you take medication for heart failure, including angiotensin receptor blockers. “Being on a good medication regimen for heart failure can improve your ability to participate in activities,” she describes.

What side effects can Entresto cause while working out?

Low blood pressure (hypotension) is one of the most common side effects of Entresto and may affect your exercise experience. Some people experience a drop in blood pressure when they go from lying down to standing up, and may experience dizziness and even fainting.

So, if you are doing any exercise routines that require you to move from a lying down to sitting up position, you should do so slowly and mindfully. For example, if you have been doing an exercise lying on your back, consider sitting up first with your feet on the floor. Take a minute to pause there, before you fully stand up.

Entresto can cause fatigue, so make sure you are well rested before you exercise, and be sure to rest afterward. Additionally, because Entresto can cause low blood pressure and increase your potassium levels, you need to stay well hydrated while exercising. Before you begin an exercise program, talk to your healthcare provider. They can help you understand what side effects to watch for, and which side effects may require medical attention.

According to the U.S. National Library of Medicine, you should contact your doctor if you experience side effects such as a cough that won’t go away or extreme fatigue. Side effects that warrant an immediate call to your healthcare provider include labored breathing, itchiness, a rash, or a swollen face, lips, tongue, or throat. These may be signs of a serious allergic reaction.

Interactions of Entresto with pre-workout supplements

Many people consider using supplements to boost energy before a workout and to help recover afterward. You should discuss any supplements you are considering taking with your healthcare provider, so you can ensure they won’t worsen your heart condition and that they won’t interact with Entresto or any medication you are taking.

Specifically, people who take Entresto should not take potassium supplements. Potassium is sometimes included as an ingredient in pre-workout powders and drinks. Make sure to read the label of the pre-workout supplement you are considering, and don’t take anything with added potassium without consulting with a healthcare provider.

You should also not take any potassium-sparing diuretics, which are sometimes called water pills, unless your doctor has told you to do so. Examples of potassium-sparing diuretics include Aldactone (spironolactone), Dyrenium (triamterene), and Midamor (amiloride). It’s also advised that you refrain from taking salt substitutes while taking Entresto.

What exercise is best for heart failure?

Congestive heart failure and physical exercise are not contraindicated, but that doesn’t mean you should dive into it full force. There are certain heart failure exercise guidelines that healthcare providers recommend you follow.

Dr. Dwivedi says that thinking along the lines of “mild to moderate” cardiovascular activity is a smart idea. Dr. Collura suggests “light aerobic” activity.

Exercises recommended by Dr. Dwivedi and Dr. Collura include:

Walking at a moderate to fast place
Light jogging
Using a stationary bike
Light resistance training
Yoga

“The main thing to remember is to start slow and progress gradually,” Dr. Dwivedi recommends. “Always listen to your body.”

It’s normal to feel some amount of fatigue as your body adjusts to exercising. “However, if you experience any chest pain, severe shortness of breath, or dizziness, please stop and consult your doctor,” Dr. Collura advises.

Can heart failure be reversed with exercise?

You might be wondering if exercising can improve heart failure, or even if heart failure can be reversed with exercise. Exercise can improve heart function for people with heart failure by strengthening their heart and cardiovascular system. Although exercise can’t reverse heart failure, Dr. Dwivedi says that it can “boost and augment the impact of heart failure therapies.” Usually, exercise therapy takes six to eight weeks to take effect, says Dr. Dwivedi.

There’s more good news, though. Not only can exercise help with congestive heart failure, it may help prevent it. Exercise helps manage many of the common conditions that can lead to heart failure, says Dr. Dwivedi, including diabetes, high blood pressure, and obesity.

Exercise can also enhance your mood, leading to smarter lifestyle and food choices, Dr. Dwivedi, which can improve your overall heart health.

So, by all means, exercise! When combined with smart choices and appropriate medication, exercise is a wonderful idea for people who live with cardiovascular disease. But, again, do make sure to check in with your doctor before beginning any new exercise routines.