Before starting an exercise program, you may want to have a stress test, which will monitor your heart while you are exercising. (BIGSTOCK)

Regular exercise and good nutrition are essential for overall health and wellness. We know that. But can exercise alone promote heart health?

The short answer is: Yes, exercise promotes heart health both in direct ways — it strengthens the heart (as it does any muscle) and allows it to work more efficiently (pump more blood with less effort) — and in indirect ones — it helps lower inflammation in the arteries and helps reduce body weight and blood pressure, says Gordon Tomaselli, chief of cardiology at Johns Hopkins University School of Medicine.

“With exercise, the vascular system becomes more responsive,” Tomaselli says.

Simply put, exercise keeps the vascular system flexible and elastic, so that blood can flow more easily. This is why someone who is well conditioned tends to have a lower resting heart rate and blood pressure than someone who rarely exercises, according to Tomaselli and the American Heart Association.

“If the heart has to push blood through a stiffened and clogged system, it has to work harder,” says Jeff Haggquist, a sports medicine doctor in the District. “So moving is inherently good for the heart,” Hagg­quist says, adding that exercise, along with other factors, “has actually been shown to reverse atherosclerosis,” or hardening of arteries.

In the 1970s, some scientists suggested that marathon running alone made you immune to hardening of arteries.

That idea has been debunked: There are plenty of serious runners with heart problems; perhaps the most famous was Jim Fixx, who helped popularize running in the 1970s and ’80s. Fixx died from a heart attack that struck him in 1984 while he was jogging. An autopsy revealed that he had major blockages in his arteries. Research since then has clearly established a link between heart health and nutrition and heredity.

Yet experts say that even for those with heart issues, exercise can play a huge role in maintaining and improving heart health.

“Ideally you are doing both” — exercising and eating a heart-healthy diet, says John Ferrell, a District-based sports medicine physician. “But even on its own, exercise can make a huge difference to promote heart health.” Just make sure you see a doctor before you start an exercise program if you have been sedentary, and maybe even do a stress test, Ferrell says.

A stress test will monitor your heart while you are doing some sort of aerobic exercise, such as walking briskly or jogging on a treadmill, and it can detect irregular heartbeats or abnormal changes in blood pressure.

“That’s where you can find out about possible artery blockages,” Ferrell says.

Ferrell recommends a stress test for anyone with a family history of heart disease or men age 40 and older, especially those who are overweight, and women age 50 and older, especially those who are overweight.

Federal guidelines and the American Heart Association recommend that adults get 30 minutes of moderate aerobic exercise five days a week, or at least 150 minutes per week of moderate exercise, or 75 minutes per week of vigorous exercise. (“Aerobic” means activity in which you use large muscle groups and breathe more intensely than you would while resting.) The AHA says that those who want to lower blood pressure and cholesterol “should average 40 minutes of moderate- to vigorous-intensity aerobic activity 3 or 4 times per week.” Following those guidelines may reduce the risk of a second heart attack, according to the medical center at the University of California at San Francisco.

If you’re starting an exercise program, experts say you should consider these recommendations in addition to discussing a stress test with your doctor:

●Start easy and progress slowly, Tomaselli says. “Promotion of exercise should be done at any age as long as we are promoting graded physical activity,” he says. If you go too fast and force your heart too hard, you may do more damage than good — even cause a heart attack, he says. “You didn’t get de-conditioned in a day, so don’t try to get reconditioned in a day.”

The key is to get those big muscle groups moving, your heart pumping and more oxygen moving through your body.

●Use a “talk test” to gauge your exercise. You should feel challenged physically but still be able to sustain the activity over time and hold a conversation while doing so.

●If you like gadgets, consider using a heart rate monitor, which straps across your chest and lets you know how fast your heart is beating. “A heart rate monitor can give you that instant feedback,” Haggquist says.

Similarly, pedometers and many smartphone apps allow you to track your activity, speed and even heart rate throughout the day.

●Don’t be put off by the idea of doing 30 minutes of exercise at one time; it’s okay to get your exercise in small doses. “Everything counts, even if it happens in 10-minute increments,” Ferrell says.

●Other types of exercising, such as strength training and flexibility work, have not been shown to be as beneficial to heart health as aerobic exercise, Tomaselli says, but they are still good for overall health.

Haggquist adds: Strength and flexibility can help support aerobic exercise and keep you injury-free. “The body is a system. Everything is connected. This is why a hip injury can lead to neck pain,” he says.

●Most important, stick with it. It’s better to do less but do it regularly than fall off the wagon entirely because you can’t face 30 minutes five times a week. As exercise becomes more of a habit, you can increase the workload.

Boston is a freelance fitness and health writer. She can be found at