The exercise routine that could reverse years of heart damage.

You probably already know that exercise is good for your heart, but there is a rather more interesting reason to keep moving as you get older. Your heart can become stiffer with age, particularly if you spend much of your time sitting down, and that stiffness can make it harder for the heart to fill properly. Researchers at UT Southwestern Medical Center and Texas Health Presbyterian Hospital Dallas found that regular exercise could actually reverse some of these changes in previously sedentary middle aged adults. In their two year randomised controlled trial, published in Circulation, 53 participants completed the study and those following the exercise programme increased their maximum oxygen uptake by 18 per cent, while measures of left ventricular stiffness also improved. In other words, your heart may have rather more capacity for renovation than your birth certificate suggests. 

The important word here is regular. The participants did not achieve these results by going for an heroic run whenever they felt guilty about eating cake. Their programme built gradually towards exercise four to five times a week, combining moderate intensity endurance exercise, higher intensity intervals and strength training. Some sessions lasted around 30 minutes, while the overall programme was tailored and supervised. Dr Benjamin Levine, Professor of Internal Medicine at UT Southwestern and founding Director of the Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital Dallas, has argued that exercise should be treated almost like personal hygiene. You brush your teeth because you would rather not discover what happens if you stop. The same principle, with considerably more sweating, applies to keeping your cardiovascular system in good condition. 

There is also an intriguing timing issue. The research focused on adults aged roughly 45 to 64, and earlier work by Levine and his colleagues suggested that the heart becomes harder to remodel later in life. That does not mean exercise suddenly becomes pointless when you reach 65. It means that the researchers found a particularly useful window in late middle age when the heart still appears responsive to training. An American Heart Association report on the research described this period as a potential opportunity for preventing future heart failure with preserved ejection fraction. So if you are in your fifties or sixties and have spent the past few decades treating the sofa as an important piece of exercise equipment, there is encouraging news. You do not need to become an endurance athlete overnight, but gradually building a consistent routine could be far more valuable than waiting for motivation to arrive wearing Lycra. 

Although you can’t literally reverse ageing, or assume that a few sessions at the gym will magically make your heart young again, what it does show is that the cardiovascular effects of inactivity are not necessarily a one way street. If you are reasonably healthy and able to exercise, a mixture of aerobic activity, occasional higher intensity work and strength training, built up gradually and performed consistently, can improve fitness and reduce measures of cardiac stiffness.

Your heart, it seems, is rather like a rubber band. Leave it sitting in the drawer for years and it gets less flexible. Give it regular, sensible use and it may surprise you with how much spring it still has.