Exercise is one of the best ways to maintain your health and for good reasons. It helps burn calories, which can help you maintain or reach a healthy weight.

According to the American Heart Association, it is recommended to get at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous aerobic activity per week. 

Apart from maintaining a healthy weight, engaging in daily physical activity prevents the risk of having a heart attack or any other Cardiovascular Disease (CVD). 

Regular physical activity is one way in which you can lower your risk of heart disease. Although any type of aerobic activity is good for the heart, running, in particular, is an effective and accessible form of exercise to improve your heart health and overall quality of life.

How is running beneficial for your heart health?

Here are a few ways how running can be advantageous for your heart health.

1. It lowers your blood pressure and cholesterol levels
Running for 30 minutes, twice to thrice a week helps reduce low-density lipoprotein (LDL), the bad cholesterol, and increases high-density lipoprotein (HDL), or good cholesterol. With frequent physical activity, your blood pressure also stabilizes.

2. It strengthens your heart muscle
Your heart is a muscle, and like any other muscle in the body, it benefits from regular aerobic activity. Over time, running strengthens the heart’s walls, which increases its overall efficiency.

3. It minimizes your heart’s workload
As your cardiovascular fitness improves, your heart muscle doesn’t have to work so hard to pump oxygen-rich blood through your body. Promoting efficient blood flow is just one way exercise helps your heart. Additionally, having a strong heart helps you cope with other physical or emotional stresses. 

4. It reduces your risk for heart disease
Running helps prevent blood clots in the arteries and blood vessels. It also supports healthy blood flow, blood pressure, and cholesterol levels.

Running and CVDs

Cardiovascular diseases (CVDs) is a general term for a class of diseases that affect the heart and blood vessels. CVDs are the leading cause of mortality in India. Currently, one in four deaths in the country is due to CVDs with ischemic heart disease (a coronary heart disease, which is a heart condition caused due to narrowed arteries) and stroke being responsible for more than 80% of the burden. Although certain non-modifiable risk factors such as age, gender, and heredity put you at a higher risk of CVD, modifiable factors such as physical activity are an important intervention in reducing the risk of CVDs, such as heart attack. 

What is a heart attack?

Your heart needs oxygen to function. A heart attack occurs when the blood flow that brings oxygen to the heart muscle is reduced or cut off completely.This happens when the coronary arteries that supply the heart with blood become narrow due to the accumulation of plaque, which is a build-up of fat, cholesterol, and other substances. This process is known as atherosclerosis. When plaque within a heart artery breaks, a blood clot forms around it. This clot can block the blood flow through the artery to the heart and cut the oxygen supply, resulting in a heart attack.

Also read: Can Stress Cause a Heart Attack?

Can running reduce the risk of a heart attack?

Many studies have repeatedly shown an inverse relationship between physical activity and the risk of CVDs. This indicates that when physical activity increases, the risk of developing CVDs reduces. Running is a great example of an aerobic activity that provides cardiovascular conditioning. It is shown to decrease the risk of high blood pressure, high cholesterol, triglyceride levels, and stroke volume.  

Here are a few points that substantiate how running can lower the probability of a heart attack.

1. Blood coagulation and fibrinolysis are two important functions that influence the formation and breakdown of clots within blood vessels. Fibrinogen is a protein responsible for forming clots and preventing excess bleeding. However, elevated levels of fibrinogen are a strong risk factor for the development of CVDs. A study by El-Sayed et al. showed the effect of exercise on fibrinogen levels. Exercise conditions of max VO2 and 75% VO2 for 30 minutes resulted in a significant decrease of plasma fibrinogen levels. The lower the concentration of fibrinogen levels, the lesser the risk of developing clots in blood vessels. 

2. Angiogenesis, which is the formation of new blood vessels, is an important aspect of cardiovascular remodeling to increase the blood flow and reduce the occurrence of ischemia.

As a result, the organs and heart get more oxygen, which is distributed evenly in the organ. In the heart, this even distribution means better oxygen supply to the muscle, thus reducing the chances of a heart attack.

3. In a study published in the Archives of Internal Medicine, it was found that long-distance runners who ran more than 80km per week had increased levels of HDL cholesterol compared to those who ran less than 16km weekly. Each 16-km incremental increase in weekly distance run up to 64km/wk to 79km/wk was associated with a rise in HDL cholesterol levels and decline in adiposity, triglyceride levels, and an estimated possibility of coronary heart disease.

4. In a study published in the Journal of the American College of Cardiology, it was found that compared to non-runners, runners had a 30% lower risk of death from all causes and a 45% lower chance of death from heart disease or stroke. On an average, runners lived three years longer compared to non-runners.

5. Over time, the heart of an athlete becomes stronger and is able to pump out the blood required by the body more efficiently. So, it needs to beat lesser number of times to achieve the same results. This leads to lowering of heart rate in the athletes, thereby reducing blood pressure. Moreover, this puts a lesser load on the heart and aids in reducing the risk of a heart attack.

How to get started with running

Here are a few ideas on how to begin your running journey:

1. Seek medical approval 

Although moderate physical activity, such as brisk walking is safe for most people, it is suggested that you talk to your doctor before you start an exercise program. If you have any known underlying conditions, heart disease, high blood pressure, or recently had a surgery, working with your doctor will help you stay on the safe path. 

2. Start small  

Commence by blocking some time in your day and start with easy runs at a conversational pace, where you can complete full sentences without going out of breath. If you have been sedentary for a while, you can start with the run/walk method and then gradually increase the running duration. Remember that every step counts.

3. Set realistic goals and be kind to yourself  

Many people who are new to exercise try to do too much, too soon, and as a result, become injured or discouraged. If you are new to running, you do not have to go all out to gain the benefits. Stick to the 10% rule, ie increase the mileage or duration by not more than 10% every week.

4. Make it a part of your lifestyle  

It is easy to prioritize other tasks and keep physical activity on the backfoot. When you make running a part of your lifestyle, go for a walk around your neighborhood, and you will probably see lots of places and opportunities to be more active. 

Also read: How to Incorporate Fitness as a Lifestyle

5. Mix your activities  

To make running-related exercises enjoyable, add some variety by incorporating cross-training activities, such as swimming, cycling, or yoga in your day-to-day life. You can also build activities into your social outings, such as going for a walk with a friend.

6. Recover well 

It might be tempting to run every day, but your recovery days are equally important. When you let your body recover, it gets the time to repair and build muscle to come back stronger.

7. Listen to your heart 

If you experience chest pain, shortness of breath, or excessive fatigue during running, stop and seek medical attention. These are red flags and may indicate an underlying condition.

Being active is a crucial part of a heart-healthy lifestyle. Eating healthy foods, not smoking, and maintaining a healthy weight are a few other ways to be heart-healthy and help prevent a heart attack or a stroke. Running, no matter how far or how fast, can reduce your risk of early death by lowering the occurrence of a heart attack. The best part is that it is never too early or late to make running a part of your life!

References
1. Dinenno FA, Tanaka H, Monahan KD, et al. Regular endurance exercise induces expansive arterial remodelling in the trained limbs of healthy men. J Physiol. 2001;534(Pt 1):287-295. doi:10.1111/j.1469-7793.2001.00287.x
2. Williams PT. Relationship of distance run per week to coronary heart disease risk factors in 8283 male runners. The National Runners’ Health Study. Arch Intern Med. 1997;157(2):191-198.
3. Tackling the Burden of Cardiovascular Diseases in India. AHA Journals. 2019; published online March 29   https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.118.005195 (accessed Aug 16, 2021) 
4. Buttar HS, Li T, Ravi N. Prevention of cardiovascular diseases: Role of exercise, dietary interventions, obesity and smoking cessation. Exp Clin Cardiol. 2005;10(4):229-249.
5. Does Running Really Reduce Your Risk of Early Death. British Heart Foundation 2019; published online November 7  https://www.bhf.org.uk/informationsupport/heart-matters-magazine/news/behind-the-headlines/does-running-reduce-risk-of-early-death (accessed Aug 16, 2021) 
6. Is Long-distance Running Good for the Heart? American Heart Association 2019; published online March 1  https://www.heart.org/en/news/2019/03/01/is-long-distance-running-good-for-the-heart (accessed Aug 16, 2021)  
7. Exercise and Cardiovascular Health. AHA Journals 2003; published online January 7  https://www.ahajournals.org/doi/full/10.1161/01.CIR.0000048890.59383.8D (accessed Aug 16, 2021)
8. Lee DC, Pate RR, Lavie CJ, Sui X, Church TS, Blair SN. Leisure-time running reduces all-cause and cardiovascular mortality risk [published correction appears in J Am Coll Cardiol. 2014 Oct 7;64(14):1537]. J Am Coll Cardiol. 2014;64(5):472-481. doi:10.1016/j.jacc.2014.04.05