Harvard Heart Letter

Ask the doctor: How do I handle conflicting advice about exercise?

Ask the doctor

How do I handle conflicting advice about exercise?

Q. In 1989, at age 45, I had my aortic valve replaced. Last year, I had an aortic dissection. My surgeon tells me not to do any cardio or resistance exercise and to keep my heart rate down. My cardiologist says I can do light cardio and resistance exercise but to watch my blood pressure. Which one should I believe?

A. Your excellent question gets to the very core of how modern medicine is practiced. The "art of medicine" is gradually being nudged aside for the "evidence of medicine." More and more, doctors try to rely on evidence-based medicine, meaning practices for which there is direct scientific evidence.

Unfortunately, most questions that patients raise haven't been answered by rigorous scientific studies. So doctors make their best judgment based on their understanding of the disease, their own experiences, and listening to peers who have more experience with that particular question. As a result, recommendations in these gray areas can vary quite a bit from doctor to doctor.

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