Sports and Supervised Exercise Programmes for Children and Young Adults with Pulmonary Hypertension. 2026 Consensus Statement from the European Pediatric Pulmonary Vascular Disease Network (EPPVDN) and the Association for European Paediatric and Congenital Cardiology (AEPC).

Pulmonary Hypertension (PH) in children and adolescents carries a significant mortality and morbidity, despite existing specific therapies. Strategies to ameliorate disease and improve outcome but also quality of life are needed. As in other pathologies, exercise as treatment and rehabilitation tool has been recently investigated also in children and young adults with PH. While evidence is not complete, available studies show its benefits. Exercise programmes can improve quality of life, reduce morbidity and positively impact on outcome parameters. Importantly, there is limited evidence on safety of exercise in PH, in particular in the paediatric population. While there are risks associated to exercise in this patient group, lack of education and guidance are equally barriers to sports and exercise participation in children and young adults with PH. This expert consensus document from EPPVDN describes exercise pathophysiology in PH, reviews the latest evidence for exercise programmes, assesses the safety of exercise and sports and for the first time gives recommendations. It follows current guidance on level of evidence classification, for structured exercise programmes but also eligibility for competitive sports.