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Love Your Heart & Work It Out

In celebration of Valentine’s Day, we at D21 want to give your heart a boost with a clear picture of heart health and the vital role exercise plays in keeping your ticker, ticking over.

We all know that exercise and a nutritious diet support a healthy heart. But, many people still have questions: What else should I do to help my heart stay healthy? How does exercise make my heart healthier? How much exercise? What kind? For how long? We’ve done the digging and found some answers!

The American Heart Association (AHA) recently published an update to their cardiovascular health guidelines. In their publication, the AHA defines a term called “ideal cardiovascular health” (iCVH) in order to monitor cardiovascular health improvements in all Americans. The AHA emphasizes the sobering fact that cardiovascular disease is the number one cause of death in the United States. After an extensive review of cardiovascular research, the AHA defines iCVH as consisting of four health behaviors and three health factors.

Mature African American Couple On Cycle Ride In Countryside

The 4 Health Behaviors

The message is simple: don’t smoke, avoid being overweight, be physically active and eat healthy food.  These health behaviors were chosen because neglecting them puts a person at the greatest risk for cardiovascular disease.  This is a simple but powerful prescription; no fads or gimmicks, these behaviors are an essential part of the formula for a healthy heart (and healthy everything else!).

The message is simple: don’t smoke, avoid being overweight,
be physically active and eat healthy food.

Men At The Gym Together

The 3 Health Factors

The three health factors follow closely from these behaviors.  Predictably, your health factors are more likely to be excellent if you engage in healthy behaviors.  First, total, untreated cholesterol should be less than 200mg/dL (milligrams per deciliter).  Second, resting blood pressure should not exceed 120/80 mmHg (millimeters of mercury; systolic/diastolic pressure).  Finally, blood glucose should not exceed 100 mm/dL after a 12hr fast.

Your health factors are more likely to be excellent
if you engage in healthy behaviors

Yet, a healthy lifestyle isn’t the only contributor to these health factors. For some people, following the advised behaviors isn’t enough to keep their health factors in excellent shape.  In addition to lifestyle, there is a significant, genetic component that underlies each person’s cholesterol levels, blood pressure and blood sugar.  Thus, the AHA says that, if diet and exercise are insufficient to maintain healthy biometrics, then these factors should be controlled with appropriate medications.

Doing crunches outdoors

The Exercise Question

This brings us to the big questions: what kind of exercise should you do, how frequently and for how long in order to maximize the benefits to your heart. The AHA has provided specific guidelines for physical activity that it calls “excellent” for cardiovascular health (iCVH):

Intermediate iCVH Excellent iCVH

1-149 min/wk moderate OR
1-74 min/wk vigorous OR
1-149 min/wk  combo

≥150 min/wk moderate OR
≥75 min/wk vigorous OR
combo (mod. + vig.)

To break it down: the AHA recommends adults get at least 30 minutes of moderate exercise OR 15 minutes of vigorous exercise, five times per week.  Moderate exercise is defined by a heart rate between 50-70% of maximum, while vigorous activity is defined by  a heart rate between 70-90% of maximum.  Maximum heart rate changes with age, so target heart rate will vary as well.  We recommend you check out  the AHA’s website or talk to your trainer about measuring target heart rate and/or using the rating of perceived exertion (RPE) system measure your workout intensity.

Adults should get at least 30 min of moderate exercise
OR 15 min of vigorous exercise 5x / week

Exercise has a plethora of heart benefits including lowering resting heart rate and blood pressure. Physical activity also helps remodel your heart so it can pump larger volumes of blood, pump stronger and pump faster.  Exercise also helps make your lungs and blood vessels stronger.  All of this means that your body has better, continuous access to oxygen and nutrients during exercise and at rest. In fact, this remodeling phenomenon has long been studied and is often termed, “athlete’s heart”.

Strengthening the heart through exercise, decreases your risk of death due to cardiovascular disease as well as death due to other causes (called “all-cause mortality”).  The specific decreased risk for any individual depends on many factors, both genetic and behavioral.  Some studies show modest changes, like 10-15% lower risk, while others demonstrate major improvements on the order of 40-45%.  Each study cohort is a different and isolating the factors that underlie big improvements is challenging.

That said, researchers agree that any exercise is better than none.  There is no, known lower limit to the cardiovascular benefits of exercise and, improvements are most pronounced in unfit people who start exercising.  However, studies show that the exercise which yields optimal benefits is regular (at least 4x/wk), sustained (at least 45 min/session) and lifelong.  Research also suggests that high intensity, interval training (HIIT) may improve cardiovascular fitness better than moderate intensity, continuous training (MICT).  Yet, more training is not always better.  Numerous studies show that extreme exercise has deleterious effects on heart health and increases injury risk.  Basically, it IS possible to train harder than your body can handle.

An exercise which yields optimal benefits is
regular, sustained and lifelong

Doctor with stethoscope holding heart

Finally, it is vital to keep up a habit of preventative care with your doctor. The AHA and American College of Cardiology emphasize the need for cooperation between patients and healthcare providers; cardiovascular health can only be improved with both input and effort from patients.  In order to achieve lasting results, we need to change our mindset to one that focuses on health, rather than a disease.  And, we need to see our health professionals as a key part of our team, rather than purveyors of unwelcome news.

We need to change our mindset
to one that focuses on health, not disease

Two older people practicing Taijiquan on the beach

So, never mind chocolate and flowers, you can keep the spirit of Valentine’s Day alive all year by showing your devotion to your loved ones: encourage their efforts to live a healthy life and take care of yourself.  Enjoy many more years of a happy, healthy life, together with the ones you love.

For more on healthy diet choices & how food can impact your emotions,
join us at D21 on Sunday, February 21st at Noon for
FOOD & MOOD with Nina Yunovich ~


Shay et. al. (2015) Understanding and improving cardiovascular health: an update on the American Heart Association’s concept of cardiovascular health.  Progress in Cardiovascular Diseases.

Knapper et. al. (2015) Time to change our focus: defining, promoting, and impacting cardiovascular population health.  Journal of the American College of Cardiology.

Bouchard et. al. (2015) Less sitting, more physical activity or higher fitness?  Mayo Clinic Proceedings.

Wilson et. al. (2015) Basic science behind the cardiovascular benefits of exercise.  Heart.



The contents of this article & website are for educational purposes and are not intended to offer individualized medical advice. You should seek the advice of your physician or other qualified health professional with any questions you may have about medical conditions. Always adhere to the advice given to you by a medical professional, even if it is different from the information provided on this website.

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