To help health professionals advise patients prior to increasing their activity there are a recognised list of absolute contraindications, which should be checked to screen patients and if any are present then treating the condition is required before activity can increase. They were developed for cardiac rehabilitation and their pre-participation health screening.

Absolute Contraindications to referral for exercise 16

  • Unstable angina,
  • Systolic blood pressure ≥ 180 and/or diastolic ≥ 100 mmHg,
  • BP drop > 20 mmHg demonstrated during ETT,
  • Resting tachycardia > 100 bpm,
  • Uncontrolled atrial or ventricular arrythmias
  • Unstable or acute heart failure
  • Unstable diabetes
  • Febrile illness

Other precautions for exercise are present in the relevant sections in the other factsheets.

Absolute contraindications taken from

BACR 2006 Phase IV Exercise Instructor Training Manual and ACSM (2009) Guidelines for Exercise Testing and Prescription. (cited 2018 Oct 20) Available from:


Health professionals are not trained in giving exercise programmes to individuals and this resource is not intended to encourage anyone to go beyond their own experience. However, guiding someone to walk, swim, cycle or dance is within everyone’s capability.

Chapter 16 - Starting to Exercise - Factsheet - download 

References: Can be found in Chapter 18

These factsheets are endorsed by the Royal College of General Practitioners (RCGP), British Association of Sport & Exercise Medicine (BASEM) and the Royal College of Nursing (RCN).





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