Secret to a Big Heart for National Heart Month

February is National Heart Month. Heart disease is the number one cause of death among men and women. Everyone knows someone who has had heart disease. My father died of a heart attack when he was 51 years old. My twin brother and I were only eight years old. This is one of my favorite photos of my father and his twin boys. Can you tell which one is me?

 Dad & twins

 While I’ve always run for competitive reasons, maybe on a subconscious level I run to prevent suffering the fate of my father. Perhaps his passing also explains my interest in cardiovascular physiology. I love the heart.


The ancient Greeks may have been the first to acknowledge the existence of the heart, which they named kardia. Our words cardiac, cardiovascular, electrocardiogram (ECG or EKG), echocardiogram, and cardiologist are all derived from that word. The Greek philosopher Aristotle thought that the heart was the seat of the soul and the center of man. But it is certainly also the most extraordinary muscle in the human body. It is always working, from before we are born until we die. It has both the unique ability and responsibility of delivering the most important chemical element—oxygen—throughout the body to sustain life. And it is how our most vital body fluid—blood—is delivered to our organs and running muscles. With running, we can actually train the heart to pump more efficiently, to pump more blood (and hence, oxygen with each beat.

The best way to strengthen your heart is exercise it, just as the best way to strengthen your biceps is to exercise your biceps. And there’s plenty of research to show that more exercise is better—the more cardiovascular exercise you do, the lesser your risk of heart disease and premature death. Despite how many people train their biceps at the gym, no one has ever died of a weak biceps muscle.

Runners literally have large hearts—specifically, the size of the left ventricle, a condition called left ventricular hypertrophy. If you’ve ever had an EKG, your cardiologist can diagnose left ventricular hypertrophy by the height of the R wave plus the depth of the S wave. When left ventricular hypertrophy occurs from endurance training, that’s a good thing; if it occurs in the absence of endurance training, it’s a bad thing, because it suggests that your heart is contracting against a resistance, which may be caused by high pressure in the aorta.

The first documented case of an enlarged heart in a distance runner may have been Clarence DeMar, who won the Boston Marathon 7 times between 1911 and 1930. A large heart is so characteristic of genetically gifted and highly trained runners that it is considered a physiological condition by the scientific and medical communities called Athlete’s Heart. Specific training can make your heart larger and increase your maximum stroke volume and cardiac output. Since cardiac output is one-half of the equation that determines the maximum volume your muscles can consume per minute (VO2max), when maximum cardiac output increases, so does your VO2max.

To make your heart larger and improve your max stroke volume and cardiac output, do an interval workout at your maximum heart rate, which causes your heart to work at it’s maximum capability to pump blood. Work like that is threatening to the heart’s survival. Your heart is very good at responding to threats, and so responds by increasing the size of its left ventricle. The larger the left ventricle, the more blood it can hold; the more blood it can hold, the more blood it can pump. Increasing the size of your left ventricle increases your maximum stroke volume and cardiac output, which sends more blood and oxygen to all of your organs. Try this workout, using the cardiovascular activity of your choice:

15 minutes warm-up
5 x 3-4 minutes @ 95-100% max heart rate with 2 minutes active recovery at a low intensity
15 minutes cool-down

For the month of February, I’m donating 10% of the profit on every Run-Fit training program downloaded from my website to the American Heart Association in memory of my father. Download your program at

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