Heart of the matter: When it comes to staying healthy, taking care of your ticker is vital.

It was William Shakespeare who wrote that a good heart is worth gold. And while it is a safe bet he was addressing the heart in a more figurative sense, his text once again lives up to modern translation and applies just as well to the importance of taking care of one’s biological heart. As the blood center of the body, it is vital to our survival. So, there is great value in working to maintain the health of the precious organ.

February is American Heart Month, so it is a great time to be thinking about how to maintain a strong heart — or get it back in tip-top shape. And Dr. Nieca Goldberg, a New York-based cardiologist and clinical associate professor of medicine, says exercise should be at the forefront of that discussion.

“People should be active and try to make their life more active in terms of walking and participating in exercises that are both aerobic and strength training,” Goldberg says.

The aerobic exercises — things such as dancing, running or swimming — are important because they move much of the body and include rapid movements (which define aerobic activities), according to Goldberg. They are associated with lowering blood pressure and “bad” cholesterol while raising levels of “good” cholesterol.

The Centers for Disease Control and Prevention says keeping one’s blood pressure under control is an important aspect of heart health. Uncontrolled, it can increase risk for heart disease, stroke, heart failure, kidney disease, pregnancy complications and cognitive decline later in life, according to the CDC. Yet, nearly 1 in 2 adults has high blood pressure, also known as hypertension, and only 1 in 4 has it under control. Hypertension is a leading risk factor for heart disease and stroke. The CDC says in 2019, more than a half-million deaths in the United States had hypertension as a primary or contributing cause.

Goldberg notes aerobic exercise also helps to improve mood.

“After you finish exercising, you feel more relaxed,” she says. “It is a great stress reducer.”

The strength training element is important because it helps people increase their lean body mass.

“You do that by improving your muscular mass,” Goldberg says. “You also find that you have more endurance to participate in aerobic exercise. If you do aerobic exercise that mainly involves your legs, and you do leg-strengthening exercises, over time you’ll find that you’ll be able to go longer distances.”

A number of factors, including age and prior health history can necessitate different approaches to how people exercise for heart health. Please see the accompanying sidebar for more information.

The CDC highlights seven healthy behaviors that can lower not only one’s risk for heart disease but also serious chronic conditions such as Type 2 diabetes and some types of cancer. Among them are learning your health history; moving more, getting at least 150 minutes of moderate-intensity aerobic activity every week, plus muscle-strengthening activities at least two days a week; and eating a healthy diet with more fruits, vegetables, whole grains, lean meats and low-fat dairy products, while reducing salt, saturated fat and added sugar. The CDC says people should also think about what they drink, including substituting water for sugary drinks and if drinking alcohol practicing moderation.

“Diet’s another important component,” Goldberg says. “To get a boost on your cholesterol-lowering, you really should combine exercise with diet. For a heart-healthy diet, it’s about following a Mediterranean-style diet that is low in meats and sweets, really rich in fruits, vegetables, whole grains.”

Plant-based fats and omega-3 from fish are “preferable,” Goldberg says. Following a good “diet” does not mean never enjoying oneself but being smart about daily choices, Goldberg says.

“Obviously, people are going to eat meats and go to a birthday party and have some birthday cake,” she says. “What’s important when you’re talking to people about how they manage their diet, it’s really also about getting rid of processed foods in your diet, because processed foods have a lot of salt and fat. It’s important to decrease simple carbs in your diet — the bread and the pasta. Certainly, the desserts would be sparingly or small portions.”

The CDC also recommends people looking to improve their heart health quit smoking, and Goldberg says that cannot be emphasized enough.

“It’s very important,” Goldberg says. “[Smoking] triples your risk for heart attack. It certainly, for people that have existing heart disease, increases the risk for recurrence. Secondhand smoke also increases risk for your friends and family if you’re smoking in their presence.”

The CDC also says people need to take medicines as directed for high cholesterol, high blood pressure or diabetes, and monitor blood pressure at home. Goldberg notes heart disease often comes with recommendations for medical therapy. People who have had heart attacks may be ordered to take a regular, low-dose aspirin treatment. Some people get cholesterol-lowering medicine, and others may need to control their blood pressure through medications.

Goldberg says people need to be vigilant with their tests, doctor follow-ups and medications. Too often, they are not.

“In the first six months after the heart attack, you see about half of the people aren’t taking their medicine,” she says.

Goldberg says technology is being used more frequently these days to help with people’s heart health. For instance, when it comes to those who have a family history or borderline risk factors but are not at a level to start medicine, a doctor may order a CT calcium score, which is a scan that can measure plaque in the coronary arteries.

“That helps the risk assessment,” Goldberg says.

Goldberg says wearable tech, such as an Apple Watch, can be beneficial to just about anyone but especially those actively trying to improve their heart health.

“It helps give people feedback on what they’re doing in between doctor’s visits,” Goldberg says.

A watch that provides feedback or tech such as an Oura Ring can help track sleep. A regular sleep schedule and quality sleep play into a number of health factors, including the heart.

“People who sleep less than seven hours of sleep a night on average have higher blood pressure and tend to have weight gain around the middle,” Goldberg says.

Myths abound when it comes to heart health, Goldberg adds. The biggest involve the levels of exercise necessary to help the heart.

“There’s a perception that you have to be like an Olympic athlete to get any benefit out of this, and that’s not true,” Goldberg says. “People really think you have to do very vigorous activity to improve heart health. The greatest gain in heart benefit is actually from a person who is sedentary and goes to moderate activity. If you then increase it to vigorous activity, you don’t necessarily get a big boost.”

People are, however, more likely to get muscle and other injuries through vigorous activities, Goldberg says. They should always seek good instruction on exercise equipment before trying new things. And be careful about overdoing it.

“Individuals who are just starting to exercise or never went [to the gym], you really have to increase in small increments if you want to up your game,” Goldberg says. “You can’t go from 0 to 180.”