Features March 2018 Issue

The Best Exercise Plan for Heart Health Has More than Aerobics

You need resistance training in addition to aerobic exercise to achieve and maintain a strong heart. Your mobility and independence depend on it.

Aerobic exercise is called cardiovascular exercise for good reason: It strengthens the heart and lungs, improving your ability to exercise longer (functional capacity), along with your stamina and fitness. If you have coronary artery disease or have had a heart attack, aerobic exercise can lower the chance of having another heart attack and increase the likelihood of living a longer life.

But aerobic exercise by itself may not be enough. Studies have shown that adding resistance training further strengthens the heart and blood vessels, as well as muscles throughout the body. For this reason the American Heart Association (AHA) recommends including resistance training in an exercise program to promote health and prevent cardiovascular disease.

“At Cleveland Clinic, we often recommend muscle-strengthening activities involving all major muscle groups on at least two days a week, in addition to regular aerobic exercise,” says Haitham Ahmed, MD, MPH, Medical Director of Cardiac Rehabilitation.

The Benefits of Aerobic Exercise

Handweight couple

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Running, walking and other forms of aerobic activity can lower your risk of heart attack. But muscle-building exercises add extra benefit by strengthening the heart and blood vessels.

Aerobic exercises are exercises that raise the heart rate. They include walking, running, biking and playing racquet sports, but may also include vacuuming, gardening and other chores that require effort.

Clinical studies confirm that regular aerobic activity can result in weight loss, reduce blood pressure and blood sugar levels, improve cholesterol, reduce inflammation and lower the risk of blood-clot formation.

You don’t need much aerobic exercise to receive its benefits. The AHA recommends 150 minutes of moderate, aerobic physical activity per week. This breaks down into 30 minutes a day, five days per week. “You can split 30 minutes into two 15-minute sessions, or even three 10-minute sessions, and still receive the health benefits,” says Dr. Ahmed.

Adding Resistance Training Helps

Resistance training exercises generally involve lifting, pushing or pulling weights. These can increase the thickness and mass of the heart muscle, which makes the heart stronger, lowers heart rate and reduces blood pressure over time. The exercises also reduce triglycerides, a nasty fat associated with increased risk of heart attack.

Additionally, resistance training appears to improve the inside layer of the blood vessels (endothelium). “This helps keep them flexible and resistant to atherosclerosis,” says Dr. Ahmed. But because lifting weights can cause blood pressure to rise while the exercise is being performed, it is important to ensure your blood pressure is under control before engaging in resistance training.

Apart from the heart and blood vessels, resistance training builds muscle throughout the body, and this can help you burn fat. “Muscle is more metabolically active than fat, so increasing muscle mass will help you lose weight—or at least prevent you from gaining weight,” Dr. Ahmed explains.

Aging Stronger

treadmill man

© monkeybusinessimages | Getty Images

Building muscle mass strengthens the bones. It also strengthens the small muscle fibers and tendons around our joints, which helps protect us from injury as we grow older. That’s why resistance exercises can help prevent frailty in older adults.

“As we age, we tend to lose muscle mass, bone density and fitness. This increases the risk of falls, injury, osteoporosis and fractures,” says Dr. Ahmed.

“Additionally, our metabolism also slows down as we get older, and we gain weight. Doing resistance training at least twice a week can help us maintain strength and stave off these risks,” he says.

Building Your Exercise Program

There’s no one-size-fits-all exercise prescription. What’s best for you will depend on your heart health, overall health, and the absence or presence of exercise-limiting conditions such as arthritis, as well as your access to a gym or home exercise equipment.

Regardless, your exercise program should include at least 30 minutes of aerobic activity five days a week and resistance training two days a week, separated by one or two days to reduce the likelihood of injury.

Ideally, your routine should work out most major muscle groups in the body. For advice in starting, ask your physician to direct you to a cardiac rehabilitation specialist or physical therapist.

“If you have heart disease, a cardiac rehab program should be your first choice. If you don’t have access to one, ask your doctor to customize an exercise prescription for you that includes adequate amounts of aerobic activity and resistance training,” says Dr. Ahmed. 

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