It's a real catch-22: on the one hand, exercise is good for your heart and your cardiovascular health, but on the other hand, exercise can put a great deal of strain on the heart. This can be especially worrisome for older or overweight people who are looking to get into better shape and want to begin new athletic training programs.

It's also why exercise machines at the gym always tell you to consult a doctor before beginning a new exercise regimen. It may be tempting to skip this step, but it might be the difference between helping and harming your heart. If you are at higher risk of cardiac problems due to age, family history, or medical issues such as high weight or high blood pressure, a doctor's visit is especially important for you.

Submaximal Stress Test

Often, when people talk about stress tests, they mean what is called a "submaximal" stress test. Stress tests involve monitoring a patient's heart, usually with an electrocardiogram. Your blood pressure and heart rate are recorded as you gradually increase the amount of exercise you do. A submaximal test is one where you stop at a predetermined heart rate, which will be determined by your doctor.

Submaximal stress tests may be used for patients who are already diagnosed with cardiac problems; by testing a particular level of exercise, it's possible to see whether it puts a strain on the heart. They are also used for healthier patients who are highly unlikely to have cardiac problems and simply want a stress test to determine their current fitness level.

Maximal Stress Test

If you are in a group at higher risk for cardiac problems, your doctor may have you take a maximal stress test instead. The American College of Cardiology considers having cholesterol higher than 320 or LDL cholesterol higher than 240, a BMI of greater than 28, diabetes, or a family history of heart disease to all be risk factors that make a maximal stress test a good idea. Your doctor will also take into account things like your age, overall health, and whether you smoke, which can all affect your risk of heart disease.

In a maximal stress test, the level of exercise is increased until either you can't keep up any more or you show signs of a cardiac problem on your electrocardiogram. This makes the test very thorough, giving the doctor a chance to see even early cardiac problems that only present themselves under extreme exercise stress.

Exercise Plan Design

If you have any problems show up on your stress test, you must absolutely work with a cardiologist in designing any exercise plan. But even if nothing shows up on your stress test, it's a good idea to ramp up your exercise gradually. While running a marathon is certainly an impressive feat, it's easy for beginning athletes to overstrain themselves with enthusiastic training; it's better to push yourself slightly and gradually increase the intensity of whatever exercise you choose.

Exercise Partner

Having someone to exercise with is a good idea for just about everyone. For people with cardiac problems or who are at risk of cardiac problems, exercising with a group means a quick response should anything go wrong. And in general, people with exercise partners or who exercise in a group are less likely to quit or skip workouts. Whether it's the companionship or competition, exercising with friends can be very helpful. Contact a company like ICE, Institute of Cardiovascular Excellence for more information.