When I left my internship in 1969, I went to the Air Force Flight Medical Officer’s training program in San Antonio, Texas – in August. Another Air Force doctor was also in San Antonio – Dr. Kenneth Cooper. He was training astronauts – and Air Force personnel – using the aerobics program – aka cardiovascular exercise.

At the “suggestion” of the company commander, I was supposed to run 1 ½ miles every day. At 235 pounds, I was not prepared for this. In the August heat, I ran out a 1/4 mile and crawled back a 1/4 mile. I thought I would die. At the end of eight weeks of Flight Medical Officer School I was running 5 miles a day and had dropped 40 pounds.

Cardiovascular exercise – the fourth type of exercise in our series – is specifically designed to improve the work efficiency of the heart and lungs, i.e. improve the ability of the body to take in oxygen and get it around to all parts of the body – thus the name “aerobics.”

Since 1969, cardiovascular exercise has become the most common type of exercise. If you want to really get all the benefits of exercise – lower blood pressure, lower LDL cholesterol, raise HDL cholesterol, improve blood sugar control, increase insulin sensitivity (decrease Type II diabetes risk), improve blood flow, decrease weight (weight control programs do not work without exercise), improve osteoporosis, increase metabolism rate, improve mental outlook, decrease stroke risk – cardiovascular exercise needs to be at the center of a complete exercise program that includes all the other modalities – balance and core muscle strength, stretching, and weight training.

So what are the basics of cardiovascular exercise? Cardio 101: exercise vigorously (until the heart rate reaches and stays at 70% of target heart rate) for 20-30 minutes at least 4 days a week.
What’s your target heart rate? 220 minus your age X 70%. Half way into the time period, stop and check your heart rate. Take your pulse for 6 seconds X 10. That’s your heart rate for a minute. Compare it to your target heart rate and adjust accordingly. If you aren’t so good at math, exercise vigorously so that you can carry on a conversation but just barely. Too winded to talk? Slow down. Too easy to talk? Speed up.
Exercise for time, not distance. Start easy – for 20 minutes, as it takes the body about that long to get in the groove. As you get used to the exercise, go longer. But establish a time that is right for you and use time as the marker, not distance.
Pick the exercise that is right for you. Walking is simple but needs to be done for at least 30 minutes. Check the heart rate and watch the time. If the heart rate is not high enough, add jogging or interval running (walk for 10 minutes – run for ten minutes). Swimming, biking, elliptical training are good exercises for those with limited use of the lower limbs – arthritis or circulatory problems. Use the same monitors – set a time and check a pulse rate. Do you like tennis, basketball, skiing, snowshoeing, soccer? Any one will do. Doing what you enjoy will increase the likelihood that you will continue to do it.
Find a way to motivate yourself to continue – variety of exercises, variety of routes, variety of times of day. Exercise with a friend (also helps in the “talk” test) or walk or run with a dog.
Some exercises need special equipment or environment. But walking and running only requires shoes. But be sure to get good shoes, the right shoes. Poor shoes will cause injury.
For men over 45 or women over 50 – especially if there is a history of heart disease in the family – check with your doctor before beginning a cardiovascular exercise program.

You don’t have 30 minutes? Divide the exercise into 10 minute intervals – although walking is best done all in one session. Walk to work or the store; don’t drive. Take the stairs; don’t ride the elevator. Walk to the next cubicle; don’t text. Get it yourself. Move. Get off the couch. Your heart will thank you.