Heart health is central to all other aspects of good health and well-being. Building good cardiovascular endurance, which is the ability to sustain physical activity without becoming quickly fatigued, will make you a fitter, healthier, and happier person.
But what is the best way to strengthen your heart so you can reap the associated wellness benefits?
In a nutshell, you’ll need to:
Have a balanced regimen of two types of exercise: cardio and strength training (resistance training)
Eat a nutrient-rich diet that keeps blood pressure and cholesterol levels healthy
Get enough sleep and manage your stress levels
In this article, we’ll flesh out the details of how to strengthen your heart and build cardiovascular endurance, as well as discuss some ways you can check your heart health progress as you go.
What Is Cardiovascular Endurance, and Why Does it Matter?
Good cardiovascular endurance allows you to perform any type of exercise that gets your heart rate up for an extended period of time (typically more than 20 to 30 minutes).
It’s also sometimes referred to as cardiorespiratory endurance, to reflect that your heart and lungs work in tandem to take in oxygen and pump oxygen-rich blood to your working muscles.
Building cardiovascular endurance doesn’t just make you feel awesome when you get a personal best time on a 5 km run or ride your bike several miles without getting winded. It’s also associated with these physical and mental health benefits:
A symptom of poor cardiovascular endurance is a higher resting heart rate, which tends to drive the sympathetic (fight or flight) arm of your autonomic nervous system. In short, if you have poor cardiovascular endurance, your body will likely be in a state of chronic low grade stress.
How to Build Cardiovascular Endurance
The way you increase your cardiovascular endurance will depend on your starting point. When starting from a sedentary base (or if you have been focusing on lifting weights but neglecting aerobic activity) it’s wise to build up slowly, over 8-12 weeks.
Ultimately, you’ll reach a point where you feel comfortable undertaking aerobic exercise, such as running, brisk walking, biking or jumping rope for relatively long periods. You should aim to build up to:
150 minutes (ex., five 30-minute sessions) per week of aerobic exercise at moderate-intensity, or 64%-76% of your maximum heart rate
75 minutes (ex., five 15-minute sessions) per week of aerobic exercise at vigorous intensity, or 77-93% of your maximum heart rate
OR a combination of the two
Your maximum heart rate can be estimated at 220 minus your age. For example, the maximum heart rate for a 35-year-old is 220 minus 35, or 185 beats per minute.
When a 35-year-old does moderate-intensity exercise, they should therefore aim to have a heart rate that is 64%-76% of this (118-141 beats per minute).
When a 35-year-old does vigorous exercise, they should aim for a heart rate of 77%-93% of their maximum or 142-172 beats per minute
Getting the Right Balance of Aerobic and Resistance Workouts
Alongside cardiovascular endurance, it’s important to develop muscular strength with resistance training (for example lifting weights).
But balance is important: If you don’t accompany resistance (strength) training with the appropriate amount of cardiovascular exercise, you might not achieve the baseline aerobic conditioning you need to get the muscle gains you are after. Research shows combining cardio and strength training is best, providing more comprehensive cardiovascular disease benefits than aerobic-only or strength-only exercise [8 Trusted SourcePubMedGo to source].
Two or three 20-minutes strength training sessions a week is a good goal for most people, though some will work harder for a lean and muscular physique.
Being over-focused on strength training, though, might actually impair cardiovascular endurance and heart health in general.
For example, one review found that too much anaerobic exercise (like strength training) could harm heart function through reducing the body’s production of human growth hormone (HGH). Too little HGH has been shown to reduce the normal thickness of the back wall of the left ventricle, its overall mass, and the amount of blood it can eject upon contraction [9 Trusted SourcePubMedGo to source].
Another review found that athletes doing endurance training (lots of cardio) did better heart-health wise than purely strength athletes. The former had significantly greater diameter and volume of the left ventricle when relaxed, indicating that the heart is pumping blood to the body more efficiently [10 Trusted SourcePubMedGo to source].
After you have a good habit of cardio and strength exercise basics, you can optimize cardiovascular endurance and associated health benefits by increasing the total time that you exercise for, or doing it at higher intensity.
Additional heart health benefits can be gained by:
Increasing to 5 hours of moderate-intensity physical activity per week
Upping your level to 2 hours and 30 minutes of vigorous-intensity exercise per week
OR a combination of the two
Adding in some HIIT sessions where you intersperse short, all-out efforts with longer periods or moderate exercise can also help strengthen your heart some more.
Healthy Heart Fundamentals
To help support and work alongside your physical training, you must have good heart health foundations. So let’s also take a look at this diet and lifestyle basics that will help underpin your cardiovascular endurance:
Though there is no one way of eating that works for everybody, a diet that is good for your heart will focus on:
Unprocessed whole foods: Plenty of vegetables, nuts, seeds, berries, oily fish and some lean meat.
Low in alcohol: While modest liquor intake (one small drink a day) likely won’t harm heart health, too much alcohol can raise blood pressure and heart disease risk.
Diets that check the above boxes include:
The Mediterranean diet: This varied diet includes vegetables, fruit, nuts, fish, legumes and olive oil. There’s very good evidence that it helps to protect against heart disease [13 Trusted SourcePubMedGo to source]. Since it is open to a wide variety of foods, some modification may be needed if you have gut sensitivities.
The Paleo diet: Paleo diets minimize carbs that can be troublesome for people with gut issues but still provides a wide variety of nutrients from lean meats, fish, veggies, and nuts. It’s generally recognized as heart-healthy but is not yet as well researched in this area as the Mediterranean diet [14 Trusted SourcePubMedGo to source].
Probiotics and Heart Health
The “gut hypothesis” of heart disease recognizes that gut inflammation and imbalances in the gut microbiome may be drivers of heart disease, via increased gut permeability that allows bad bacteria AND inflammatory chemicals to enter the bloodstream [15 Trusted SourcePubMedGo to source, 16 Trusted SourcePubMedGo to source].
Probiotics (supplements of good bacteria) can therefore be of potential benefit for heart health by addressing gut imbalances.
A 2020 systematic review / meta-analysis of randomized controlled trials (high quality evidence) found that when people at risk of heart disease took probiotic supplements, they benefited from [17 Trusted SourcePubMedGo to source]:
Reduced systolic and diastolic blood pressure
Lowered total cholesterol and a better balance of LDL (“bad”) of HDL (“good”) cholesterol
Improved blood sugar levels
Reduced body mass index (BMI)
Sleep and Relaxation
Getting enough rest and managing stress are other important components of good heart health.
Managing psychological and emotional stress is important because too much stress can raise blood pressure and even trigger a heart attack in extreme cases .
Along with your cardiovascular endurance exercise program outlined above, other simple ways to manage stress include:
Talking therapy, either with a friend you trust, or a counsellor
Getting enough quality sleep helps prevent high blood pressure, obesity, and diabetes, which are all strong risk factors for heart disease . National Sleep Foundation guidelines suggest 7-9 hours is about right for most adults [20 Trusted SourcePubMedGo to source].
To help improve your sleep quality try these tips:
Try to have consistent sleep and waking times, even on weekends .
Wind down before bed — for example, with a warm bath, meditation, or reading a book .
You might want to monitor your progress toward having a stronger heart and better aerobic fitness.
Regularly check these physical functions:
Your blood cholesterol level (including total, HDL and LDL cholesterol)
Your blood triglyceride level
Your blood pressure
By tracking these with a doctor, you can monitor what is happening with your heart health over time (obviously seeking medical advice on any issues of concern).
Assessing Cardiovascular Endurance
A useful way to assess your cardiovascular endurance is the VO2 max test. This shows how efficiently your heart and lungs work together to get the required amount of oxygen to the large muscles that power your workout.
The most accurate VO2 max testing is in an exercise lab, but this isn’t readily available to most people. However, you can get a good idea of your VO2 max and cardiovascular endurance using a couple of at-home tests. You can then repeat these over time to see your progress.
The first, called the Cooper test, essentially involves running as far as you can outside or on a treadmill for 12 minutes. You plug your results into a calculator which then estimates your VO2 max.
You can also do the tests on a rowing machine while rowing 2000 meters. Here too, you’ll enter your details (age, time and weight in this case) into a calculator and track your progress over time.
The Bottom Line for a Stronger Heart
To recap, there’s no magic solution when it comes to boosting your cardiovascular endurance. It involves raising your heart rate and moving your body on a regular basis. But you can build up gradually and achieve good results with as little as five 30-minute, moderate-intensity exercise sessions a week and two 20-minute strength sessions a week.
Being mindful of your diet, sleep, and stress management — think of them as the essential building blocks upon which you build optimal heart health.
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