It would be prudent, however, to monitor patients who have demonstrated exercise-induced arrhythmias and those patients with advanced HF.335 Although the safety and efficacy of resistance train- ing have not been established in this population,335 re- sistance training can offer the opportunity to strengthen individual muscle groups and has been shown to be ef- fective without safety issues in small trials with patients Small free weights (1, 2, or 5 lb), elas- tic bands, or repetitive isolated muscle training can be but the safety of resistance training in patients with HF needs to be further established in larger trials.335 Recommendations Harmonized With Existing Guidelines See Tables 13 and 14 for a summary of these recom- mendations. Dietary Guidelines in Patients With HF Typical dietary guidelines for the HF population state that sodium restriction or fluid restriction in patients with severe HF with congestion and with hyponatremia is rea- Otherwise, there are no specific recommenda- tions for caloric intake or dietary composition included in the current AHA/ACCF, Heart Failure Society of America, or European Society of Cardiology HF guidelines8,29,317 other than nutritional supplements not being recom- mended as treatment of HF in patients with current or prior symptoms of HFrEF.8 Guideline Recommendations for Exercise With the above background, the Heart Failure Society of America, European Society of Cardiology, ACC, and AHA recommend exercise training or regular physical activity in patients with HF,8,29,249,317,318 but these guidelines have Management of Comorbidities in Chronic Heart Failure CLINICAL STATEMENTS AND GUIDELINES not addressed the beneficial role of exercise in preven- tion of HF, which we tried to address by adding a rec- ommendation stating the beneficial role of exercise or physical activity for patients with stage A or B HF. 