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Physical activity strengthens the heart and can help ward off a cardiac event. Here’s what to do, and why it works.
By: Melissa Daly
Medical Reviewer Tiffany Asp, D.P.T.
You know you need to move your body in order to keep it healthy. This is particularly true when it comes to protecting your heart.
“Exercise is the ‘magic pill’ for heart health,” says clinical exercise physiologist Brian Cleven, head of the cardiac and pulmonary rehabilitation program at Bellin Health Marinette in Marinette, WI. And it can quite literally mean the difference between life and death: People who are physically active have a 21% lower risk of cardiovascular disease and a 36% lower risk of dying from diseases of the heart or blood vessels, according to a research review in the Journal of the American Heart Association.
So how much exercise do you need, and how exactly does it help ward off heart trouble? “We call it the rule of fours: 40 minutes of continuous physical activity four days per week gives you at least four benefits,” says Guy Mintz, M.D., director of cardiovascular health and lipidology at Northwell Health System in Manhasset, NY. “It improves your blood pressure, blood sugar, cholesterol, and aerobic capacity—that is to say, it makes your heart stronger.” (Note that Dr. Mintz’s recommendations are close to the U.S. government’s physical activity guidelines; see below.) Consistent weekly exercise also improves heart risk factors by reducing levels of inflammation in the body, helping keep weight in check, and boosting your mood, adds Cleven.
How Much
How Much Exercise Do You Need for Heart Health?
Although every little bit of activity helps, the American Heart Association recommends the following guidelines for adults (which also matches the government’s Physical Activity Guidelines for Americans):
- At least 150 minutes of moderate-intensity aerobic exercise a week, or 75 minutes of vigorous aerobic activity, or a combination of both, ideally spread throughout the week
- At least two days of moderate- to high-intensity muscle strengthening activities
- Less time sitting
That amount can feel daunting, until you realize just how many different activities there are to get you there. So which of them is best for heart health?
If you’re looking for the most direct route to a stronger heart, cardio exercise is likely your best bet. Activities that get your heart beating faster, like jogging or swimming, train the heart to pump blood and transport oxygen more efficiently. Activities that strengthen or stretch your muscles, like lifting weights or doing yoga, can increase your metabolism and prevent injuries, so it’s easier for you to stay active. Ultimately, though, most experts go by the philosophy that something is better than nothing when it comes to heart health. “The best exercise for an individual is the one that you’re comfortable with and are happy to do,” says Dr. Mintz.
Cardio
How Cardio Helps Your Heart
Cardiovascular, or aerobic, exercise is any continuous, rhythmic activity using large muscle groups (like your legs) fueled by the oxygen you breathe, per the American Council on Exercise. These are endurance activities that you can do for a relatively long time, like dancing or cycling.
“Aerobic exercise strengthens the heart muscle, which helps it pump blood more efficiently and effectively both during exertion and at rest,” says Cleven. “You often will see lower resting heart rates and less of a spike in heart rate with exertion after developing an exercise routine.” Regular moderate-to-vigorous activity improves the ability of the heart to pump blood to the lungs and throughout the body, while also widening the tiny blood vessels known as capillaries, so more oxygen is delivered to key organs, per the National Heart, Lung, and Blood Institute (NHLBI). Exercise boosts the amount of blood circulating through your body by up to 25%, which helps blood vessels expand and become more flexible. In addition, aerobic exercise helps reduce the risk of heart disease by lowering blood pressure and triglyceride levels, increasing levels of “good” HDL cholesterol, and reducing levels of C-reactive protein (a sign of inflammation), according to the NHLBI.
Researchers at the University of Cambridge recently concluded that one in 10 cases of cardiovascular disease could be prevented if everyone did even half the recommended amount of moderate-intensity exercise, such as brisk walking—about 11 minutes a day.
Aerobic exercises include:
- Aerobic classes
- Boxing
- Cycling
- Dancing
- Elliptical machine
- Hiking
- Rowing
- Running
- Swimming
- Walking
Strength Training
How Strength Training Helps Your Heart
Strength training is a type of anaerobic exercise—a short, intense burst of exertion (like lifting a dumbbell)—that’s fueled by glucose within the muscles you’re using. In addition to making your muscles more powerful so that it’s easier to keep your body (and your heart) active, this type of exercise can also benefit your cardiovascular system in other ways. “Strength training can lead to improvements in lean muscle mass, which can improve your metabolism and your control of several heart risk factors, including blood pressure and cholesterol. Strength training also provides a positive effect on how your muscle cells accept blood sugar, called insulin sensitivity,” says Cleven. In short, working muscles get better at absorbing glucose from the bloodstream, so your body requires less insulin to be released. That, in turn, lowers the risk of type 2 diabetes, which itself can contribute to heart disease.
In a research review published in the British Journal of Sports Medicine, muscle-strengthening activities alone were associated with a 17% lower risk of cardiovascular disease. Combining strength exercise with aerobic activity upped the CVD risk reduction to 46%.
Using more resistance—for example, a heavier dumbbell that you can only manage to lift about five to eight times—will generally provide a greater challenge to the heart and lead to a higher heart rate and blood pressure response, says Cleven. A 10-year study in Journal of Epidemiology & Community Health found subjects with the highest levels of skeletal muscle mass had an 81% lower risk of developing a cardiovascular disease event compared to those with the lowest level of muscle. (Note that if you are new to weightlifting, it’s best to start out with a lighter load to avoid injury risk). But lifting lighter has its own benefits: Doing more repetitions with a lighter weight will boost muscle endurance, so that you can do more of the physical activities you like without tiring out.
Strength-building exercises include:
- Calisthenics like pushups and sit-ups
- Free weights/dumbbells
- High intensity interval training (HIIT)
- Pilates
- Resistance bands
- Sprinting
- Weight machines
Flexibility & Balance
How Flexibility/Balance Training Helps Your Heart
Lighter exercises like stretching, twisting, or balancing on one leg are still exercise—and every little bit helps. “Anything that increases your heart rate—and stretching can do that for some—is beneficial to the heart,” says Dr. Mintz.
But the primary benefit of flexibility exercise, when it comes to heart health, is the supportive role it can play in keeping your body healthy enough to engage in cardio activity. “We want everybody to stretch because it prevents injuries,” says Dr. Mintz. Making your muscles more flexible helps to increase your range of motion, while improving your balance means you’re less likely to stumble or fall. Plus, “flexibility exercise may lead to less pain with movement, which allows a person to do more of the activities they love with less discomfort,” adds Cleven.
Flexibility and balance workouts can also be calming (think yoga and tai chi), which ties back to heart health: “These activities have the potential to reduce stress, help improve circulation, and lower levels of inflammation in the body,” says Cleven. According to a recent meta-analysis in the journal Current Problems in Cardiology, yoga can even modestly improve blood pressure, cholesterol, and blood sugar.
Flexibility and balance exercises include:
- Qigong
- Stretching
- Tai chi
- Yoga
Daily Activity
The Importance of Being Active Throughout the Day
Lacing up your shoes for a 1.5-mile walk or hitting the weights is a great start to improving heart health, but 30 minutes of activity won’t erase ten (or more!) hours of sitting at a desk or on the couch. “Some of the risks of prolonged sitting include slowing of the metabolism, higher levels of inflammation, weight gain, increased risk of blood clots in the legs, and decreased insulin sensitivity,” says Cleven.
Luckily, breaking up your down time with even a quick bout of activity now and then appears to counteract the health effects of prolonged sitting, according to a review by researchers at Indiana University. “My recommendation is for folks to get up and move each hour. Walk, stretch, or even do a few chair squats to keep the blood flowing,” says Cleven. “A good common-sense method is when you start feeling a bit stiff or notice a ‘screen fog’ setting in, then get up and move your body.”
Here are a few more ways that you can keep moving throughout the week:
- Choose an activity like visiting a museum, bowling, or mini golf rather than a movie.
- Use a standing desk at work.
- Get in the habit of walking around when on the phone.
- March in place during commercials and credits on TV binge nights.
- Park further away from your destination.
- Set a phone timer to ping you to get up at regular intervals.
- Tackle a home improvement project instead of scrolling social media.
Safety
How to Exercise Safely With Heart Disease
If you’ve already been diagnosed with a heart condition or have family or personal risk factors, talk with your doctor before starting or changing your exercise routine. “That’s where personalized medicine comes in,” says Dr. Mintz. “Your cardiologist can weigh in on exactly how many minutes, miles per hour, and level of incline to use. If you’re not a cardiac patient, your primary care physician can evaluate your risk factors and determine whether further evaluation is needed before clearing you for exercise.”
In addition, if you are taking any medication that can affect your heart (such as diuretics), talk to your doctor regarding how your body may respond to exercise.
If you’re picking up exercise after a long layoff (or just getting active for the first time!) there are a few guidelines to follow that can make it a safer, more enjoyable experience. “Warm up or ease into your activity to let your body adjust and gear up to the greater challenge, and cool down at the end of exercise,” says Cleven.
It’s also important to gradually build up to a consistent routine, adding minutes or intensity to your workout slowly over time. “A gradual, stepwise progression will generally result in less soreness, less risk to the heart, and a better long-term relationship with exercise,” says Cleven. A physical therapist can also be a good resource to discuss exercise recommendations with a chronic condition.
It’s also important to listen to your body as to how long and how hard you work out. That’s especially true if you have a chronic concern like high blood pressure or type 2 diabetes. If you experience any of these warning signs, stop exercising and talk to your doctor.
- Dizziness
- Extreme fatigue
- Faintness
- Nausea
- Pain
- Shortness of breath
Target Zones
Know Your Target Heart Rate Zones
Knowing your target heart rate—or the range within how fast your heart beats during exercise—can help you safely reach some of your training goals. This is based on the idea of maximum heart rate, which in general is about 220 minus your age, according to the American Heart Association. Your target heart rate during moderate intensity activity like brisk walking is about 50% to 70% of your maximum heart rate. During vigorous activity like running, it’s about 70% to 85% of maximum heart rate.
Per the American Heart Association, here are the average target heart rate zones for 50%-85% of max heart rate based on your age group:
Age: Target Heart Rate Zones (beats per minute)
20-29 years old: 100-170 bpm
30-34 years old: 95-162 bpm
35-39 years old: 93-157 bpm
40-44 years old: 90-153 bpm
45-49 years old: 88-149 bpm
50-54 years old: 85-145 bpm
55-59 years old: 83-140 bpm
60-64 years old: 80-136 bpm
65-69 years old: 78-132 bpm
70-74 years old: 75-128 bpm
75-79 years old: 73-123 bpm
80-84 years old: 70-119 bpm
85-89 years old: 68-113 bpm
90+ years old: 65-111 bpm
Takeaways
Takeaways
Regular physical activity is one of the best things you can do to help your heart, and that’s true even if you have a chronic condition like heart disease. Aerobic exercise (like brisk walking, dancing, or jogging) can strengthen your heart muscle, while resistance training improves your metabolic health and makes it easier to do activities of daily living, so you’re more active in general. Even flexibility and balance exercises can help in fighting stress and increasing activity. The best exercise for your heart? It’s the one you enjoy enough to keep doing.
This article was originally published March 31, 2008 and most recently updated April 2, 2024.
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