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9.1. Recreational Physical Activity and Competitive Sports
COR LOE
Recommendations
1 B-R
1. For patients with HCM, mild- to moderate-intensity*
recreational
†
exercise is beneficial to improve
cardiorespiratory fitness, physical functioning, and quality
of life, and for overall health in keeping with physical activity
guidelines for the general population.
1 C-EO
2. For athletes with HCM, a comprehensive evaluation and
shared decision-making about sports participation with an
expert professional is recommended.
2a B-NR
3. In individuals who are genotype-positive, phenotype-negative
for HCM, participation in competitive sports of any intensity
is reasonable.
2a B-NR
4. For patients with HCM, participation in vigorous*
recreational activities is reasonable after an annual
comprehensive evaluation and shared decision-making with
an expert professional who balances potential benefits and
risks.
2b B-NR
5. For patients with HCM who are capable of a high level of
physical performance, participation in competitive sports
†
may be considered after review by an expert provider with
experience managing athletes with HCM who conducts an
annual comprehensive evaluation and shared decision-making
that balances potential benefits and risks.
3: No
benefit
B-NR
6. For most patients with HCM, universal restriction from
vigorous physical activity or competitive sports is not
indicated.
3: Harm C-EO
7. In patients with HCM, ICD placement for the sole purpose
of participation in competitive sports should not be
performed.
* Exercise intensity can be gauged by METS: light <3 METs, moderate 3–6 METs, and
vigorous >6 METs, by % maximum heart rate achieved (light 40%–50%, moderate
50%–70%, vigorous >70%), or by level of perceived exertion on the Borg scale (light 7–12,
moderate 13–14, vigorous ≥15).
†
Recreational exercise is done for the purpose of leisure with no requirement for systematic
training and without the purpose to excel or compete against others. Competitive sports
involve systematic training for the primary purpose of competition against others, at
multiple levels, including high school, collegiate, master's level, semiprofessional, or
professional sporting activities.
9. Lifestyle Considerations for Patients With HCM
