Exercise for Heart Health

Last updated: March 23, 2021

Exercise for Heart Health

Ahmed Raza

Fitness. (© GDJ/Wikimedia Commons/CC0 1.0)

Sitting in a chair or on the couch for more than six hours a day can lead to destructive effects on the body. Here are a few disturbing facts:

It’s hard to emphasize the impact of heart disease. Consider the following:

One might debate that the $300 billion the nation spends on treating CVD is a necessary expense; however, it is suggested that 90% of CVD is preventable. Non-modifiable risk factors for heart disease include age, gender, and family history.

People can take measures to protect themselves from heart disease starting from childhood and into adulthood. The most important step is to live a healthy lifestyle that includes not only eating healthy but also creating a healthy exercise plan.


Benefits of exercise for the heart

Exercise is a lifestyle intervention for both prevention and treatment of heart disease. Evidence suggests that regular, moderate exercise with a healthy diet can have the following benefits:

Results differ from study to study, but on average, physical exercise can increase high-density lipoproteins (HDL) and has shown to decrease triglycerides and low-density lipoproteins (LDL).

Exercise is also known to reduce LDL particle number, which may be one of the most significant lipid markers that determine the risk for heart disease.


Nervous system, exercise, and the heart

Image 2 HRV

Heart rate variability.MarkJohnDave at Commons/CC-BY-SA-4.0)

The heart at rest was once believed to act much like a metronome, consistently beating at a regular, steady rhythm. Researchers now understand that this is far from the case.

Rather than being monotonously regular, the rhythm of a healthy heart—even under resting conditions—is irregular, with the time interval between consecutive heart beats changing. This normal occurring beat-to-beat variation is known as the heart rate variability (HRV).

The natural variability in the heart rate is due to the action of the two branches of the autonomic nervous system (ANS)—the sympathetic and parasympathetic branches.

The two branches interact to maintain cardiovascular activity within an optimal range and to permit reactions to changing internal and external conditions. The sympathetic nerves increase the heart rate, while the parasympathetic nerves, such as the vagus nerve, slow it down.

As an indicator of resilience and behavioral flexibility, the heart rate variability reflects the body’s ability to adapt adequately to internal and external stressors and demands, such as exercise, breathing patterns, and emotions.

A higher HRV is thought to offer a survival advantage, whereas reduced HRV may be correlated with poorer cardiovascular health and outcomes. A lower HRV indicates a need for stress reduction, rest, and sleep. A natural decline in HRV also occurs with aging.

To improve heart rate variability research suggests getting plenty of sleep, practice stress relieving activities, and regular physical exercise.


Improving HRV is not the same as increasing the heart rate, which also has beneficial effects on the heart. The heart is the body’s built-in system that measures exercise intensity. The heart rate will rise in proportion to the intensity of the exercise. It is recommended to track and guide exercise intensity by calculating the target heart rate range.


What to include in an exercise program

Image 3 Adaptations to long term aerobic and anaerobic exercise

Adaptations to long-term aerobic and anaerobic exercisePlin7/Wikimedia Commons/CC-BY-SA-3.0/GFDL)

Before defining exercise guidelines, it is essential to recognize inactivity. Physical inactivity is a term used to identify individuals who do not get the advised level of regular activity.

The Physical activity guidelines for Americans, explain that people need two types of physical activity each week to enhance overall health—aerobic and muscle-strengthening.

  • 2 hours and 30 minutes (150 minutes) of moderate-intensity aerobic activity (i.e., brisk walking) every week and
  • muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).


  • 1 hour and 15 minutes (75 minutes) of vigorous-intensity aerobic activity (i.e., jogging or running) every week and
  • muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).


  • An equivalent mix of moderate- and vigorous-intensity aerobic activity and
  • muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).

When creating an exercise program, one must include not only the training portion of working out but also necessary steps to prepare the heart and help prevent injury.

These measures include warming up, cooling down, and dynamic stretching. Keep in mind that numerous studies indicate that stretching alone will not prevent injury.

Warm up occurs before the actual exercise or when conditioning begins. It involves as little as 5 minutes to as long as 15 minutes of light intensity cardiovascular or resistance activities.

Warming up will gradually increase blood flow to the muscles, dilate blood vessels, and decrease the amount of stress on the heart.

A cool down takes place after the exercise. It will safely and slowly bring the heart rate down. As with the warm-up, 5 to 15 minutes of stretching or a short walk will suffice.

Cardiovascular exercises for heart health

In physical fitness, “cardio” is a common term used when talking about aerobic or endurance exercises.

Cardiovascular exercises are those that work out the heart and lungs thereby causing an increase in one’s heart rate and respiration. Over time the left ventricle adapts and enlarges—this dilatation allows the ventricle to hold more blood and to eject more blood per beat, even at rest.

When performing this type of exercise, movements are often steady and rhythmic.

Also, cardio exercises may result in positive changes such as weight loss and reduced blood pressure—both are beneficial to reducing the risk of acquiring heart disease.

Keep in mind that the goal is to add frequent movement. Endurance exercises that a person can perform indoors and outdoors may include:

Strengthening exercises for heart health

Resistance training helps strengthen and protect the heart and improve stamina. The heart adapts to strength training by increasing the thickness of the left ventricle wall (this differs from cardiac hypertrophy of pathological origin).

Anything that puts a demand on the muscles—including so-called anaerobic activities such as weightlifting—will also condition the heart and vascular system.

Exercises include:

Breathing exercises for heart health

Regular practice of controlled breathing is shown to improve cardiovascular and respiratory functions and decrease the effects of stress. To combat chronic stress, an individual can apply breathing exercises throughout the day.

Resources for various types of breathwork:

Heart healthy exercise considerations

When to check with a healthcare provider

Although physical activity, such as brisk walking, is safe for most people, it is suggested that individuals consult a healthcare provider before the start of an exercise program. The healthcare provider may recommend routine blood pressure and pulse measurement and annual blood tests. Some instances may require an electrocardiogram (ECG) or stress testing to indicate how the heart responds to stress.

People should consult a practitioner before starting an exercise program if any of the following is present:

Cardiac rehabilitation

Exercise performed under medical supervision is proving to be therapeutic for select patients with stable heart failure.

Every patient is different; therefore, the patient should obtain specific guidelines for their condition.

To assess a person’s capacity and to set safe exercise limits according to a particular situation, the cardiologist may collaborate with an exercise physiologist.

Guidelines and considerations for exercise after a cardiac event may include:


Importance of having life-support training

Because cardiac arrest often strikes suddenly and without warning, it is crucial to have life-support training as a healthcare provider, caretaker, or family member of a person with cardiovascular disease.

Please contact us at to reach the author and recommend other guidelines and considerations that interest you.

Written by on Apr 19, 2017

Sarah has worked in various roles at Coffee Medical Center including nurse, education director, and quality assurance director.

Last reviewed and updated by on Apr 28, 2020

Caitlin Goodwin, DNP, RN, CNM, is a Board Certified Nurse-Midwife, Registered Nurse, and freelance writer. She has over twelve years of experience in nursing practice.

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