Heart Health Isn’t Just Cardio: A Physical Therapist’s Guide for Women Over 40

Haley Smith
1 day ago
3 min read

Contributed by: Haley Smith, DPT

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February has been American Heart Month since 1964. When most women hear heart health, they immediately think of walking, running, or time on the elliptical. And while those activities are great cardiovascular exercise options, your heart can benefit just as much from other forms of exercise!

What Counts as Cardiovascular Exercise?

When we talk about “cardio,” we’re really talking about how hard your heart is working. One of the simplest ways to understand this is through heart rate zones.

Cardio zones are based on a percentage of your maximum heart rate. You can find your estimated maximum heart rate with your age and a simple math equation:

220 - your age = estimated max heart rate

Zone	% max heart rate	Feels like	Examples	Best For
Zone 1	50-60%	Easy, talk in full sentences	Recovery, easy walking	Warm up, cool down, beginners, active rest
Zone 2	60-70%	You can talk, but not sing	Brisk walk/hike, swimming, steady cycling	Majority of cardio should be spent here
Zone 3	70-80%	Elevated breathing, talk in short phrases	Jogging, cycling intervals, cardio class	not required daily. Too much time here without recovery can increase injury risk, fatigue, and burnout.
Zone 4	80-90%	Talking is difficult	Sprint intervals, HIIT	Should be brief, intentional, and well-recovered

How Much Cardio Do You Really Need?

The general recommendation is:

● 150 minutes per week of moderate cardio → That’s about 30 minutes, 5 days a week

My weekly recommendation is:

● Most cardio time in Zone 2

● Zone 1 movement for warm up and warm down or recovery

● Optional short efforts in Zone 3 or 4

PT bonus tips:

● Consistency matters more than intensity—especially for joint health and injury prevention. Doing something regularly is far more beneficial (and sustainable) than pushing too hard and burning out or getting injured.

● Those minutes do not have to happen all at once. Ten- to fifteen-minute chunks absolutely count.

● Movement should support your nervous system - not constantly push it into survival mode.

What About Strength Training?

Strength training is VITAL to women’s health and longevity. As a physical therapist, I often emphasize strength training even more than traditional “cardio.”

When done intentionally, strength training can absolutely count as cardiovascular exercise. By shortening rest breaks and lifting weights that truly challenge you (so you’re reaching muscle fatigue well before 30 repetitions) you can easily reach the Zone 2 heart rate zone.

For most women, I recommend strength training each major muscle group 2–3 times per week, which typically looks like 3–5 total lifting sessions per week.

If you want to add more traditional cardio, a long walk on a recovery day or a walk after your strength workout is a simple, joint-friendly way to support heart health without overloading your body.

Heart Health Isn’t Just About Workouts.

Recovery plays a powerful role in cardiovascular health, especially for women navigating busy schedules, hormonal changes, and chronic stress.

Important (and often ignored) factors include:

● Sleep quality and consistency

● Breathing: especially slow, controlled breathing to calm the nervous system

● Chronic stress, which is directly linked to elevated heart risk

Practice intentional deep breathing, meditation, or mobility work. Limit screen time at least two hours before bed, and be mindful of how much you’re putting on your plate.