Stay active, boost your heart health. It’s a simple enough directive, but contrary to what you might think, the connection comes down to way more than maintaining a healthy weight.
Sure, exercise — whether it’s walking, running, lifting weights or just taking the stairs — can help fight obesity, one of the five primary modifiable risk factors of heart disease. And with obesity being closely related to three of the other heart-disease risk factors (high cholesterol, high blood pressure and Type 2 diabetes), managing your weight can have a large impact on your overall risk. In fact, a 2015 study concluded that addressing these risk factors could prevent half of all deaths from heart disease.
However, physical activity takes on heart health even more directly. “The heart is merely a muscle; if you use it, it is strong and fit,” says cardiologist and heart surgeon Steven Gundry, MD, founder of the Center for Restorative Medicine in Palm Springs, California.
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Exercise strengthens the muscle for better and stronger contractions, meaning that over time, the heart can beat at a slower rate while pumping out the same amount of blood to the rest of your body. And as exercise increases the flexibility of the arteries that flow from the heart, blood pressure is reduced and blockages are prevented. As a result, the heart doesn’t have to work as hard.
A key marker for heart health, called N-terminal pro b-type natriuretic peptide, is produced and released from the heart when it is stretched and working hard to pump blood. NT-proBNP is commonly measured to detect and evaluate heart failure.
“[NT-proBNP] literally tells me how hard the heart is working, whether there are leaks or narrowing in valves, or whether the heart muscle is getting weak or too thick,” says Gundry. “I measure this number every three months in my patients. Whenever I see this number suddenly worsen, the first thing I ask my patients is if they have changed their exercise program. And sure enough, almost 90% of the time, the answer is yes. One time, the patient’s dog had died, and since they were no longer walking a dog, their activity levels and heart health had dropped.”
In fact, while it only takes about three months of regular activity to make a substantial boost in heart health, inactivity can lead to even faster declines, says Regina Druz, MD, a cardiologist with the Integrative Cardiology Center of Long Island. For instance, in one Journal of Applied Physiology study, when healthy men reduced their daily step counts from roughly 10,000 to 1,500, their cardiovascular fitness declined in just two weeks. And in a 2014 Nutrition, Metabolism and Cardiovascular Diseases study, when obese adults took a break from their workout programs, it only took a month to lose most of cardiovascular benefits — including cholesterol levels — that they had made in the previous four months of regular exercise.
“If you don’t use it, your heart’s newfound strength vanishes quicker than most people think,” says Gundry.
THE BEST EXERCISE FOR YOUR HEART
While Gundry says strength training is your best bet for improving your metabolic health and getting to a healthy weight (both of which have a large effect on heart health), cardiovascular or aerobic exercise has a greater direct effect on resting heart rate and blood pressure. He notes that by increasing the intensity of your strength training and performing fast-paced circuits, you can get your heart rate up so your strength workout doubles as cardio.
“Having said that, we know that excessive aerobic exercise, such as running more than five miles per day, damages the heart muscle, through measurements monitored with another test called Cardiac Troponin I,” says Gundry. “This test is 100 times more sensitive than the test I use in the emergency room to look for a heart attack. I frequently see elevations of this marker — not a good thing — in runners, marathoners, extreme hikers and, wow, do I see it in CrossFitters!”
After all, a 2015 Journal of the American College of Cardiology study of more than 5,000 healthy adults (both joggers and nonjoggers), found that logging cardio is a bit of a Goldilocks scenario: While light and moderate joggers have a lower risk of death than sedentary folks who don’t jog, strenuous joggers enjoyed no such benefit. While cardiovascular exercise can stress the heart in order to make it adapt and become stronger, too much stress can weaken the heart.
For overall cardiovascular health, the American Heart Association recommends performing at least 150 minutes of moderate-intensity aerobic activity like brisk walking or jogging per week or 75 minutes per week of vigorous aerobic activity like running or cycling sprints. The organization notes that performing strength training at least two days per week can convey additional benefits (think: fat loss and a metabolic boost).
Before taking up aerobic exercise, talk to your doc — especially if you are over 50 or have existing heart problems. “In many situations, individuals with specific heart issues may be eligible for cardiac rehabilitation programs, and those are a great way to get appropriate level of exercise while supervised,” says Druz. “Despite their effectiveness, these programs are underutilized. Ask your doctor to recommend a local cardiac rehabilitation program for you, or have them refer you to an exercise physiologist for assessment.”
Written by K. Aleisha Fetters, a health and fitness writer, and a certified strength and conditioning specialist through the NSCA. You can read more from Aleisha at kaleishafetters.com or follow her on Twitter at @kafetters.