If you want to maintain a healthy heart, follow the old adage: use it or lose it.

In other words, get off the couch, put down the remote, and get yourself some exercise. Go dancing. Fly a kite. Take the family skiing – and maximize your heart health.

That’s the advice of Dr. Patrick Green, a cardiologist who practices at the UCHealth Heart and Vascular Clinic – Harmony Campus.

“Regular physical activity and increased levels of physical fitness are associated with lower rates of many chronic diseases, including cardiovascular disease,” he said.

This is mostly mediated by favorable effects on cardiovascular risk factors such as high blood pressure, elevated cholesterol, prevention of diabetes and help to maintain healthy body weight, he added.

So how much exercise does a normal adult heart need?

“I encourage my patients to try and do something physically active every day. The American Heart Association recommends at least 30 minutes of moderate-intensity aerobic exercise or activity at least 5 days a week for a total of 150 minutes.”

Dr. Green doesn’t usually recommend one exercise over another to achieve better heart health.

“Any physical activity is better than none at all,” he said. “The important thing is finding an activity that one finds enjoyable so that the behavior will be maintained over time.

“Any activity is fine, such as gardening, mowing the yard or walking the dog,” Dr. Green said.

He recognizes that not everyone is fit enough to hit the treadmill or take a strenuous hike. Personal limitations have to be taken into account – such as arthritis, an old injury, and so on. But almost anyone can do something, he said.

“Find an activity that can be done comfortably,” Green advised. “Enlist the help of a fitness professional at a local gym or physical therapist.”

Some people who cannot exercise comfortably on land can do fine in a swimming pool, for example. If a patient who was previously sedentary wants to start exercising, he suggests they pace themselves.

“Most people can safely begin an exercise regimen if they start slowly (low intensity) and build gradually over time,” he said. “If one has significant risk factors, it would be prudent to see their provider prior to starting a regular program.

“Everyone should see their health care provider periodically and have their risk factors assessed,” he added.

It’s never too early or too late to start exercising

“Regular exercise/physical activity should start when we are young and continue life-long,” Green said.

If exercise is so good for you, why are we always hearing about runners having heart attacks?

“Regular exercise lowers the risk of heart disease but does not completely eliminate it,” he explained. “I have experience seeing runners that continue to run despite having chest pain (angina).

“If one experiences discomfort in their chest or shortness of breath that is out of proportion to what they usually feel during exercise, they need to STOP and be seen by their health care provider! I cannot emphasize that enough. Even if you are an experienced runner with no obvious heart disease risk factors, do not ignore these symptoms.”

Is it possible to exercise too much?

“There is some growing concern that, for some people, you can have too much of a good thing,” Green said. “Endurance athletes may be at higher risk for developing atrial fibrillation and other heart rhythm problems. Whether or not endurance exercise increases the risk of heart attack is an unanswered question and area of ongoing research.”

Green provides his patients with the following information about exercise and heart health from the American Heart Association.

Tips for exercise success from the American Heart Association

Swimming, cycling, jogging, skiing, aerobic dancing, walking or dozens of other activities can help your heart. They all cause you to feel warm, perspire and breathe heavily without being out of breath and without feeling any burning sensation in your muscles. Whether it is a structured exercise program or just part of your daily routine, all exercise adds to a healthier heart. Exercise can help lower your risk of heart attack, stroke and death, help you maintain healthy body weight and help you feel more energetic.

Here are some tips for exercise success:

• If you’ve been sedentary for a long time, are overweight, or have a high risk of coronary heart disease or some other chronic health problem, see your doctor for a medical evaluation before beginning a physical activity program.
• Choose activities that are fun, and not exhausting. Add variety. Develop a repertoire of several activities that you can enjoy. That way, exercise will never seem boring or routine.
• Wear comfortable, properly fitted footwear and comfortable, loose-fitting clothing appropriate for the weather and the activity.
• Find a convenient time and place to do activities.  Try to make it a habit, but be flexible. If you miss an exercise opportunity, work activity into your day another way.
• Use music to keep you entertained.
• Surround yourself with supportive people.  Decide what kind of support you need.  Do you want them to remind you to exercise?  Go with you to a special event, such as a 10K walk/run?  Be understanding when you get up early to exercise? Make a date with a family member, friend or co-worker.  Be an active role model for your children.
• Don’t overdo it.  Do low- to moderate-level activities, especially at first.  You can slowly increase the duration and intensity of your activities as you become more fit.  Over time, work up to exercising on most days of the week for 30-60 minutes.
• Keep a record of your activities.  Reward yourself at special milestones.  Nothing motivates like success!

Tips for adding physical activity in your daily life

Adding physical activity at home

It’s convenient, comfortable and safe to work out at home. It allows your children to see you being active, which sets a good example for them. You can combine exercise with other activities, such as watching TV.  If you buy exercise equipment, it’s a one-time expense, and other family members can use it.  It’s easy to have short bouts of activity several times a day. Try these tips:

• Do housework yourself instead of hiring someone else to do it.
• Work in the garden or mow the grass. Using a riding mower doesn’t count!  Rake leaves, prune, dig and pick up trash.
• Go out for a short walk before breakfast, after dinner or both!  Start with 5-10 minutes and work up to 30 minutes.
• Walk or bike to the corner store instead of driving.
• When walking, pick up the pace from leisurely to brisk. Choose a hilly route. When watching TV, sit up instead of lying on the sofa. Better yet, spend a few minutes pedaling on your stationary bicycle while watching TV. Throw away your video remote control. Instead of asking someone to bring you a drink, get up off the couch and get it yourself.
• Stand up while talking on the telephone.
• Walk the dog.
• Park farther away at the shopping mall and walk the extra distance.  Wear your walking shoes and sneak in an extra lap or two around the mall.
• Stretch to reach items in high places and squat or bend to look at items at floor level.
• Keep exercise equipment repaired and use it!

Adding physical activity at the office

Most of us have sedentary jobs. Work takes up a significant part of the day. What can you do to increase your physical activity during the workday? Why not…

• Brainstorm project ideas with a co-worker while taking a walk.
• Walk down the hall to speak with someone rather than using the telephone.
• Take the stairs instead of the elevator. Or get off a few floors early and take the stairs the rest of the way.
• Walk while waiting for the plane at the airport.
• Stay at hotels with fitness centers or swimming pools and use them while on business trips.
• Participate in or start a recreation league at your company.
• Join a fitness center or Y near your job. Work out before or after work to avoid rush-hour traffic, or drop by for a noon workout.
• Schedule exercise time on your business calendar and treat it as any other important appointment.
• Walk around your building for a break during the work day or during lunch.

Adding exercise to play

Play and recreation are important for good health. Look for opportunities such as these to be active and have fun at the same time:

• Plan family outings and vacations that include physical activity (hiking, backpacking, swimming, etc.)
• Make a date with a friend to enjoy your favorite physical activities. Do them regularly.
• Play your favorite music while exercising, something that motivates you.
• Dance with someone or by yourself. Take dancing lessons.
• Join a recreational club that emphasizes physical activity.
• When golfing, walk instead of using a cart.    .

Exercise tips when adding more activity to your daily life

You should always stay within your physician’s recommendations and your own comfort zone. Here’s a checklist of what to do and what to avoid.

What to DO when adding activity to your daily life:

• Wear comfortable clothes and flat shoes with laces or sneakers.
• Start slowly. Gradually build up to at least 30 minutes of activity, five or more times per week (or whatever your doctor recommends). If you don’t have 30 minutes, try two 15-minute or three 10-minute sessions to meet your goal.
• Exercise at the same time of day, so it becomes a habit. For example, you might walk Monday through Friday from noon to 12:30 p.m.
• Drink a cup of water before, during and after exercising (but check with the doctor, because some people need to limit their fluid intake).
• Ask family and friends to join you. You’ll be more likely to keep exercising.
• Note your activities on a calendar or in a log book. Write down the distance or length of time of your activity and how you feel after each session. If you miss a day, plan a make-up day or add 10–15 minutes to your next session.
• Use variety to keep your interest up. Walk one day, swim the next time, then go for a bike ride on the weekend.
• Join an exercise group, health club or YMCA. Many churches and senior centers offer exercise programs, too. (Get your doctor’s permission first.)
• Look for chances to be more active during the day. Walk the mall before shopping, choose a flight of stairs over an escalator, or take 10–15 minute walking breaks while watching TV or sitting for some other activity.

What NOT TO DO when adding activity to your daily life:

• Get discouraged if you stop for a while. Get started again gradually and work up to your old pace.
• Do isometric exercises that require holding your breath, bearing down or sudden bursts of energy. If you’re taking part in an exercise class or physical therapy, ask the leader or therapist what these are. Also, avoid lifting weights and competitive or contact sports, such as football.
• Engage in any activity that causes chest pain, shortness of breath, dizziness or lightheadedness. If these happen, stop what you’re doing right away.
• Exercise right after meals, when it’s very hot or humid, or when you just don’t feel up to it.