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How to improve heart health with exercise

Regular exercise can be helpful in preventing cardiovascular risk factors, maintaining a healthy cardiovascular system, and promoting rehabilitation after a cardiac event.

Even just a single 30-minute exercise session can produce immediate benefits and exert a protective short-lasting effect on hearth health through a process called ischemic preconditioning.1 Ischemic preconditioning describes how exercise can train the heart to adapt to situations of insufficient blood flow.1 This acquired adaptive capacity can be protective against cardiac events such as heart attack.1

Over time, regular endurance exercise improves the heart’s physiology and contractility reducing the effort required to pump the blood. Additionally, the parasympathetic nervous system can become less reactive resulting in lower blood pressure and heart rate.2 Overall, changes in vascular endothelial and myocardial health protect against cardiovascular risk factors including hyperglycemia, obesity, blood pressure, and hyperlipidemia.2

The American Heart Association (AHA) recommends prescribing exercise post a cardiac event such as stroke to improve cardiovascular health.3

The AHA recommends:

  • At least 2.5 hours of weekly moderate-intensity activity or 75 minutes of weekly high-intensity activity or a combination of both 4
  • Gradually increasing time and intensity of exercise 4
  • Incorporating resistance training to build muscles 4

1. How to improve heart health with aerobic exercise? 

Aerobic or cardiovascular exercise improves circulation and lowers blood pressure. Aerobic exercise includes those activities designed to increase the heart rate to burn calories and fats and additionally strengthen the heart. Some common cardio exercises include fast walking, swimming, dancing, and cycling.

The CDC suggests that moderate-intensity aerobic exercise for 2.5 hours per week 

  • lowers the risk for cardiovascular diseases 5
  • reduces the risk of stroke 5
  • lowers blood pressure 5
  • regulates levels of cholesterols 5
  • regulates blood sugar 5
  • reduces the risk of type 2 diabetes and metabolic syndrome 5

A popular option is interval training. Interval training combines short high-intensity cardio exercise (e.g., running) with longer active recovery periods (e.g., walking). It is important to keep in mind that high-intensity exercise is not recommended in elderly people with congestive heart failure or coronary artery disease.2

2. How to improve heart health with resistance training exercise?

Resistance or weight training helps to build muscle mass and burns fats. Animal studies suggest a potential of resistance training in improving cardiac function, contractility, blood pressure, and endothelial dysfunction.6 However, human studies are controversial: isometric resistance training may be beneficial for cardiac function in younger people but not in older adults.7

Currently, it seems that resistance training could be incorporated in combination to endurance exercises to enhance the effects of aerobic fitness on heart health.8

3. How to improve heart health with coordinative exercise?

Coordination is the foundation of many exercises and, through the combination of balance, flexibility, breathing and relaxation exercises, it might have some potential in improving heart health.

It has been shown that Tai Chi may improve heart health in older adults; the intensity and volume of exercise have to be furthered studied.7,9

Yoga has been suggested as a possible activity to incorporate to prevent cardiovascular disease since it may contribute to reduce stress, blood pressure, cholesterol, and regulate blood glucose.10 Additionally, it has been found that yoga could be beneficial in cardiac rehabilitation after coronary artery bypass.10 Large high-quality multicenter studies are required to confirm the preventive and rehabilitative potential of yoga on heart health.10

Pilates strengthens core muscles, improves balance and flexibility.  In people suffering from chronic cardiovascular diseases, it can improve exercise tolerance.11 It has been shown that in obese females, pilates not only reduces body fat but also improves vascular function, hypertension, and cardiovascular complications.12

It has been found that even a single pilates session can show promising results in lowering blood pressure.13 In combination with aerobic exercise its effects could be potentiated since it has been found that practicing pilates under hypoxic conditions elicits an additive effect on the metabolic and cardiac responses.14

Always speak with your healthcare provider before beginning any exercise plan, to make sure it is right for you.


1.Thijssen DHJ, Redington A, George KP, Hopman MTE, Jones H. Association of Exercise Preconditioning With Immediate Cardioprotection: A Review. JAMA Cardiol. 2018 Feb 1;3(2):169-176. doi: 10.1001/jamacardio.2017.4495. PMID: 29188285.

2. Chowdhury, M. A., Sholl, H. K., Sharrett, M. S., Haller, S. T., Cooper, C. C., Gupta, R., & Liu, L. C. (2019). Exercise and Cardioprotection: A Natural Defense Against Lethal Myocardial Ischemia-Reperfusion Injury and Potential Guide to Cardiovascular Prophylaxis. Journal of cardiovascular pharmacology and therapeutics24(1), 18–30.

3. Kleindorfer, D. O., Towfighi, A., Chaturvedi, S., Cockroft, K. M., Gutierrez, J., Lombardi-Hill, D., Kamel, H., Kernan, W. N., Kittner, S. J., Leira, E. C., Lennon, O., Meschia, J. F., Nguyen, T. N., Pollak, P. M., Santangeli, P., Sharrief, A. Z., Smith, S. C., Jr, Turan, T. N., & Williams, L. S. (2021). 2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association. Stroke52(7), e364–e467.



6. Melo, S., da Silva Júnior, N. D., Barauna, V. G., & Oliveira, E. M. (2018). Cardiovascular Adaptations Induced by Resistance Training in Animal Models. International journal of medical sciences15(4), 403–410.

7. Grässler, B., Thielmann, B., Böckelmann, I., & Hökelmann, A. (2021). Effects of different exercise interventions on heart rate variability and cardiovascular health factors in older adults: a systematic review. European review of aging and physical activity : official journal of the European Group for Research into Elderly and Physical Activity18(1), 24.

8. Hollings, M., Mavros, Y., Freeston, J., & Fiatarone Singh, M. (2017). The effect of progressive resistance training on aerobic fitness and strength in adults with coronary heart disease: A systematic review and meta-analysis of randomised controlled trials. European journal of preventive cardiology24(12), 1242–1259.

9. Väänänen, J., Xusheng, S., Wang, S., Laitinen, T., Pekkarinen, H., & Länsimies, E. (2002). Taichiquan acutely increases heart rate variability. Clinical physiology and functional imaging22(1), 2–3.

10.Manchanda S. C. (2014). Yoga–a promising technique to control cardiovascular disease. Indian heart journal66(5), 487–489.

Miranda S, Marques A. Pilates in noncommunicable diseases: A systematic review of its effects. Complement Ther Med. 2018 Aug;39:114-130. doi: 10.1016/j.ctim.2018.05.018. Epub 2018 Jun 8. PMID: 30012382.

11. Miranda, S., & Marques, A. (2018). Pilates in noncommunicable diseases: A systematic review of its effects. Complementary therapies in medicine39, 114–130.

12. Wong, A., Figueroa, A., Fischer, S. M., Bagheri, R., & Park, S. Y. (2020). The Effects of Mat Pilates Training on Vascular Function and Body Fatness in Obese Young Women With Elevated Blood Pressure. American journal of hypertension33(6), 563–569.

13. Rocha, J., Cunha, F. A., Cordeiro, R., Monteiro, W., Pescatello, L. S., & Farinatti, P. (2020). Acute Effect of a Single Session of Pilates on Blood Pressure and Cardiac Autonomic Control in Middle-Aged Adults With Hypertension. Journal of strength and conditioning research34(1), 114–123.

14. Jung, K., Seo, J., Jung, W. S., Kim, J., Park, H. Y., & Lim, K. (2020). Effects of an Acute Pilates Program under Hypoxic Conditions on Vascular Endothelial Function in Pilates Participants: A Randomized Crossover Trial. International journal of environmental research and public health17(7), 2584.

Photo by Pixabay from Pexels



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