Regular physical activity remains one of the most powerful strategies for preventing heart disease. While nearly all forms of exercise can offer health benefits, a comprehensive routine that incorporates three distinct types of physical activity—moderate aerobic, vigorous aerobic, and strength training—may provide the greatest cardiovascular protection, according to a 2024 review published in Trends in Cardiovascular Medicine.
The Case for Combining Exercise Types
Moderate-intensity aerobic exercise, such as brisk walking, serves as the foundation of this multi-faceted approach. As outlined in federal physical activity guidelines, adults should aim for at least 150 minutes of moderate-intensity activity per week, or 75 minutes of vigorous-intensity activity, or a combination of both. Moderate aerobic activity promotes weight control, boosts metabolism, and burns calories—all factors that support heart health.
Vigorous aerobic activity, such as running or indoor cycling, further enhances these benefits by increasing cardiovascular demand and stimulating the release of feel-good neurochemicals like endorphins and endocannabinoids. These chemical responses can contribute to the phenomenon often referred to as a “runner’s high,” said Dr. Tim Churchill, a cardiologist with the Cardiovascular Performance Program at Massachusetts General Hospital, affiliated with Harvard Medical School.
Incorporating high-intensity elements helps suppress the body’s “fight or flight” response—a key contributor to chronic stress and anxiety. These exercises also activate hormones like adrenaline, which compel the heart to beat faster and more forcefully. Over time, the cardiovascular system becomes more efficient, reducing the heart’s workload. Blood vessels also become more flexible, aiding circulation and promoting long-term heart health.
The Role of Strength Training
Strength or resistance training, often overlooked in cardiovascular regimens, plays an equally crucial role. Engaging in muscle-building exercises at least twice weekly can have a synergistic effect when combined with aerobic exercise.
“Strength training improves how the body burns fat and regulates insulin, both of which are essential for preventing or managing diabetes—a major risk factor for heart disease,” Dr. Churchill explained. It also stimulates the production of nitric oxide, a molecule that relaxes blood vessels and helps maintain healthy blood pressure.
Recommended methods for muscle strengthening include free weights, resistance bands, weight machines, or bodyweight exercises like push-ups and squats. Activities such as heavy yard work, gardening, or certain yoga styles—such as Ashtanga or Vinyasa—can also serve as effective resistance training.
Exercise Examples by Intensity
Moderate-Intensity Aerobic Activities:
Walking on a level surface (2.5–4.5 mph)
Recreational swimming
Cycling on flat terrain (5–10 mph)
Doubles tennis
Light hiking
Indoor cycling at a moderate pace
Vigorous-Intensity Aerobic Activities:
Brisk walking (above 4.5 mph) or walking uphill
Jogging, running, or stair climbing
Cycling at speeds over 10 mph or uphill
Spin classes or high-intensity indoor cycling
Singles tennis
Continuous lap swimming
Muscle-Strengthening Activities:
Weightlifting with dumbbells, kettlebells, or machines
Bodyweight exercises (push-ups, sit-ups, squats)
Resistance band workouts
Intense gardening tasks (digging, shoveling)
Power yoga styles (Ashtanga, Iyengar)
Holistic Benefits Beyond Metrics
The benefits of combining all three forms of exercise extend beyond conventional health markers. According to the review, this integrated regimen yields greater reductions in resting heart rate, blood pressure, body weight, and body fat percentage than any single mode of exercise alone.
“Exercise improves numerous cardiovascular risk markers, but even when added together, those improvements only explain about 50% of the overall health benefits we observe with regular physical activity,” Dr. Churchill noted. The remaining benefits are likely tied to complex physiological responses that are not easily captured by standard measurements.
For individuals unsure of how to begin such a program, medical professionals recommend tailoring the routine to one’s age, baseline fitness level, and health status. A healthcare provider can offer guidance on developing a safe, balanced plan that maximizes heart health outcomes.
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