Getting your heart pumping with regular exercise is one of the best things you can do for your cardiovascular health. But what kind of workout should you do? How much is enough? And is it ever too much?

Advanced heart failure and transplant cardiologist Christina Dunbar Matos, DO, answers these questions and more to help you create an exercise routine that keeps your heart strong.

Why exercise matters for your heart

Exercise treats many of the risk factors that can cause or worsen heart disease. When you move your body regularly, you help to manage:

• High blood pressure.
• High cholesterol.
• Obesity.
• Diabetes.
• Stress.

Exercise lowers cholesterol by contributing to weight loss and changing how your body burns energy. Whether you’re burning carbohydrates or fats depends on the type of exercise you do and how long you do it.

“We know exercise in and of itself causes blood pressure to reduce,” Dr. Dunbar Matos says. “When done consistently, there are long-term benefits with that.”

The best type of exercise for your heart

If you had to pick just one type of exercise, cardiovascular exercise that gets your heart rate up should be your top choice. This includes activities like walking, jogging, running and swimming.

But Dr. Dunbar Matos emphasizes that the best exercise is one you’ll actually do. When she talks with patients about physical activity, she always asks what activities they enjoy.

“Right now, everyone likes to play pickleball,” she says. “Pickleball gets your heart rate up, gets you moving your muscles, and that can be your exercise.”

How much exercise do you need?

The American Heart Association recommends:

• 150 minutes of physical activity per week.
• Preferably 30 minutes a day, five days a week.
• At least two days of weight training.

Weight training is an important addition to your cardio routine. It helps build muscle strength and supports overall heart health.

Can you exercise too much?

Yes, you can overdo it. While you may not necessarily harm your heart, you can hurt the rest of your body.

“If you’re a runner and you run too much, or you haven’t conditioned yourself to run and you really push yourself, then you’re going to have issues with injuries,” Dr. Dunbar Matos explains.

Too much intense exercise can also cause muscle breakdown, which releases substances that can lead to kidney issues, high blood pressure and other problems that affect your heart.

Starting an exercise program safely

If you haven’t exercised in years, start slowly. If you have underlying health issues, talk to your primary care provider or cardiologist first.

“Don’t expect to get up and do 30 minutes at one time,” Dr. Dunbar Matos advises. “That’s your goal, to work towards that.”

If you can only exercise for five to 10 minutes at a time, do that two or three times a day with breaks in between. Gradually work your way up to 30 minutes.

Exercising with a heart condition

If you already have a heart condition, you can still exercise safely. In fact, Dr. Dunbar Matos strongly recommends it.

“Anyone with pretty much almost any type of heart condition, whether you’ve had a heart attack, stents, heart surgery or valves, as part of the healing process, we recommend going to cardiac rehab,” she says.

The Nebraska Medicine Cardiac Rehabilitation Program helps you get back to physical activity safely under professional supervision. The staff can determine what intensity will get you to your target heart rate without overdoing it.

Consistency over intensity

What matters most for heart health: working out hard or doing it consistently? The answer is clear.

“Consistently is the key,” Dr. Dunbar Matos says.

Many patients ask her what type of exercise to do, how long to work out, how hard to push themselves or even what time of day is best.

Her advice: “Whatever is going to keep you consistent with what you’re doing is what you should do.”

Common myths about exercise and heart health

Dr. Dunbar Matos sees two main misconceptions in her practice:

1. Fear after a cardiac event: Many people are reluctant to exercise after a major heart problem. Cardiac rehab can give you the confidence to safely return to physical activity.
2. “I don’t have time”: You don’t need hours at the gym. Even 10 minutes at a time helps. Take the stairs instead of the elevator. Park farther away when shopping. Small changes add up over time.

No gym? No problem

Hate going to the gym? There are plenty of alternatives:

• Walk inside a large store like Walmart.
• Join a mall walking group.
• Do arm curls with soup cans or other weighted items at home.
• Do squats or other bodyweight exercises.
• Get a dog that needs daily walks.

“Just anything to get your heart rate going and your blood moving is good,” Dr. Dunbar Matos says.

Understanding target heart rate

Many patients ask Dr. Dunbar Matos how hard they should work out. A general formula for a heart rate goal is 220 minus your age. Depending on your health issues, you should aim for 60% to 80% of that number.

However, medications can affect this calculation, so it’s important to talk with your doctor about your specific target heart rate.

If you’re an overall healthy person without heart conditions, you can aim for closer to your calculated maximum heart rate (220 minus your age).

Finding accountability

One final tip from Dr. Dunbar Matos: find ways to hold yourself accountable. This could be:

• An exercise buddy who counts on you to show up.
• A journal where you track your workouts.
• A log of your activity to share with your doctor.

“I love it when my patients bring me a log of their weight, blood pressure, their exercise programs that they do,” she says.

Get more information

For more heart-healthy advice, tips and information, visit our heart hub.