Training the Big Three: Heart, Lungs and Your Circulation
I like hearing that people have been doing things that get them out of breath. Unless it's a horror film. Or an old photo you don't remember being taken, the one with the mullet, or the Hawaiian shirt. That's more having your breath taken away.
The good kind is the kind you do on purpose, and you're glad you did.
Cardio gets talked about as one thing. It's three. Your heart, your lungs and your circulation, working as a team. Train them together and you lower the odds of the nasty preventable stuff, and you pick up a pile of everyday wins that most people care about far more.
Meet the big three
Your heart is the pump. It pushes blood round with every beat, and a stronger pump shifts more with less effort.
Your lungs are the supply. They pull oxygen in and hand it over to the blood, ready for delivery.
Your circulation is the delivery network. Miles of vessels carrying oxygen and fuel to every muscle that asks, then taking the rubbish away.
Get all three working together and that's cardiovascular fitness.
What training does to each one
Your heart gets stronger. A trained heart pushes more blood per beat, so it beats less often to do the same job, climbing stairs or sitting still.
Your lungs, and the whole system that takes oxygen and turns it into effort, get better at the work. In a four-month study of 101 people with an average age of 67, aerobic training raised peak oxygen uptake by 11.6% and the point at which the body starts to labour by 13% [1].
Then the one nobody mentions. Your arteries get more elastic. Stiff arteries are a risk in their own right, and a study in Circulation found endurance-trained middle-aged and older men had central arteries 20 to 35% more compliant than sedentary men. Better still, twenty sedentary men who did three months of mostly walking-based exercise caught up to the trained group, without any change in weight, body fat, blood pressure or fitness score [2]. Men only in that study, so bear that in mind, but it's a striking result.
The medical side, told straight
I love my community, and I don't want to see anyone in it sick because of something preventable. So, without dressing it up:
A 2026 systematic review in BMC Geriatrics looked at adults aged 65 and over. Of 16 studies on cardiovascular disease, 14 found lower risk with greater activity or fitness, and every study that followed people over time found lower death rates among the fitter and more active [3].
The best single number I've seen comes from Taiwan. Researchers gave 13,423 people aged 65 and over a two-minute step test, then followed them for seven years. The fittest fifth had a 42% lower risk of dying from any cause than the least fit fifth [4]. The honest footnote: balance, agility and chair-stand scores were linked even more strongly. Aerobic fitness matters, and it isn't the whole story.
Fitness also tells you something your usual check-up numbers don't. In 66,371 adults without heart disease, followed for 16 years, adding a fitness measure to the standard risk factors (age, sex, blood pressure, diabetes, cholesterol, smoking) made the prediction of cardiovascular death more accurate at 10 and 25 years out [5].
Now the straight bit. Most of this is observational. Fitter people do better, and training reliably improves fitness and vessel elasticity. Nobody has run a fifty-year trial, so I won't pretend every link in the chain is nailed down.
One more. The same 2026 review found better blood sugar handling with higher fitness in 12 of 16 studies, while the findings on body fat were all over the place [3]. Put plainly: your body can get better at managing blood sugar even when the scales don't move much.
The everyday side, which is the bit you'll actually notice
Getting to the front of the queue at the carvery, ahead of the rush, for the best cuts of the roast. And still having enough breath left to give them your order.
Being able to chase your dog across the park and still shout its name when you get there.
Finishing the gardening with enough in the tank for a reward, rather than needing a three-hour nap.
Those aren't only jokes. They're what the function research describes. A systematic review of people over 65 found moderate or high activity was associated with roughly half the odds of running into limitations in everyday tasks [6]. And in a proper trial, LIFE-P randomised 424 sedentary people aged 70 to 89 who were at risk of losing their mobility. The group doing moderate activity improved their physical performance scores and their 400-metre walking speed against a health-education group. The longer-term disability result pointed the right way but wasn't statistically firm, so I'll say that rather than overclaim [7].
Tricia put it simply: "Wonderful classes, highly recommend. Really feel I am benefiting and my fitness is improving. Especially appreciate the fact that classes are recorded so can catch up later if needed."
What to actually do
The weekly dose, plainly. In 17,088 people whose activity was measured by wearable rather than memory, 150 minutes a week of moderate to vigorous activity went with roughly an 8 to 9% lower cardiovascular risk. Reductions above 30% went with far bigger volumes, around 560 to 610 minutes a week [8]. The first is the target. The second is where it can go, not where it has to.
Add strength alongside it, because that's what improves everyday function most. In 136 sedentary older adults over six months, aerobic and combined training both improved insulin resistance, every exercise group improved on everyday function, and combined training beat aerobic alone on that measure [9].
And do it with people. A trial across 56 neighbourhoods and 582 people aged 65 and over ran leader-led walking three times a week for six months. Against an information-only control, it improved physical and mental quality of life, life satisfaction and how much people actually walked [10]. That's the reason this is a community and not a video library.
The classes that get you puffing are Strength with me, Zumba Gold with Row and Dancercise with Anna, all live on Zoom. There are 15+ live classes a week, every one recorded, and 1,000+ on-demand videos behind them. Most work in a living room with little or no kit, and many have seated and standing options.
I film from a studio near Stroud, Gloucestershire, but Jim's Gym is online, wherever you are in the UK.
Quick questions, straight answers
What is cardiovascular fitness, and why does it matter after 55?
Cardiovascular fitness is how well your heart, lungs and circulation work together to get oxygen to your muscles. After 55 it tracks with lower heart disease risk and lower death rates: in a 2026 review, 14 of 16 studies found lower cardiovascular risk with greater fitness or activity [3].
How much cardio should I do each week?
Aim for at least 150 minutes a week of moderate to vigorous activity. In 17,088 people with wearable-measured activity, that level went with roughly an 8 to 9% lower cardiovascular risk, and larger reductions came with much bigger volumes [8]. Start at the target, and let it grow if you enjoy it.
Is it too late to start in my 60s or 70s?
No. In a four-month study of people averaging 67, aerobic training raised peak oxygen uptake by 11.6% [1]. In LIFE-P, 424 sedentary adults aged 70 to 89 improved their physical performance and 400-metre walking speed with moderate activity [7]. The body still responds well into later life.
What does cardio do to my blood vessels?
It makes them more elastic. Endurance-trained middle-aged and older men had central arteries 20 to 35% more compliant than sedentary men, and three months of mostly walking-based exercise brought sedentary men up to similar levels, independent of weight or blood pressure [2]. That study included men only.
Will it actually help with everyday things like gardening and walking the dog?
Yes. A systematic review found moderate or high activity was associated with roughly half the odds of everyday functional limitation in people over 65 [6]. Combining strength work with cardio improved everyday function more than cardio alone in a six-month trial of 136 older adults [9].
Your next step
Start with the free Fitness MOT. Five exercises at home, no scoring, retaken every four to six weeks so you can watch your own numbers move.
Then join Jim's Gym and find the class that gets you out of breath the good way. It's £12.99 a month with a 30-day money-back guarantee, no contracts and no joining fees. Join for the year and get 2 months on me.
Front of the carvery queue. Breath to spare. It's never too late.
James Hilton is the founder of Jim's Gym, an online fitness community for adults over 55, based in Stroud, Gloucestershire. He set it up for people who want to keep doing the things they love, with classes, community and a fair bit of laughing along the way.
Our affordable monthly membership is great for those just starting out or may need to take a break for a big adventure! The yearly option gives you two months FREE membership with a 30 day money back guarantee.
References
J. A. Blumenthal et al., "Cardiovascular and behavioral effects of aerobic exercise training in healthy older men and women," Journal of Gerontology, 1989, 44(5):M147-M157. https://doi.org/10.1093/geronj/44.5.M147
H. Tanaka, F. A. Dinenno, K. D. Monahan, C. M. Clevenger, C. A. DeSouza and D. R. Seals, "Aging, habitual exercise, and dynamic arterial compliance," Circulation, 2000, 102(11):1270-1275. https://doi.org/10.1161/01.CIR.102.11.1270
A. M. Madden, L. M. Soepnel et al., "Aerobic physical activity, cardiorespiratory fitness, and non-communicable diseases risk in older adults: a systematic review," BMC Geriatrics, 2026. https://doi.org/10.1186/s12877-026-07541-4
M.-C. Wu, C.-T. Hsu, H.-T. Hsu et al., "Physical fitness and all-cause mortality in older adults," JAMA Network Open, 2026, 9(8):e2628227. https://doi.org/10.1001/jamanetworkopen.2026.28227
S. Gupta et al., "Cardiorespiratory fitness and classification of risk of cardiovascular disease mortality," Circulation, 2011, 123(13):1377-1383. https://doi.org/10.1161/CIRCULATIONAHA.110.003236
D. H. Paterson and D. E. R. Warburton, "Physical activity and functional limitations in older adults: a systematic review related to Canada's Physical Activity Guidelines," International Journal of Behavioral Nutrition and Physical Activity, 2010. https://doi.org/10.1186/1479-5868-7-38
M. Pahor, S. N. Blair, M. Espeland et al. (LIFE Study Investigators), "Effects of a physical activity intervention on measures of physical performance: results of the LIFE-P study," Journals of Gerontology Series A, 2006, 61(11):1157-1165. https://doi.org/10.1093/gerona/61.11.1157
Z.-D. Liang et al., "Joint non-linear dose-response associations of device-measured physical activity and cardiorespiratory fitness with cardiovascular disease: a cohort and Mendelian randomisation study," British Journal of Sports Medicine, 2026. https://doi.org/10.1136/bjsports-2025-111351
L. E. Davidson et al., "Effects of exercise modality on insulin resistance and functional limitation in older adults: a randomized controlled trial," Archives of Internal Medicine, 2009, 169(2):122-131. https://doi.org/10.1001/archinternmed.2008.558
K. J. Fisher and F. Li, "A community-based walking trial to improve neighborhood quality of life in older adults: a multilevel analysis," Annals of Behavioral Medicine, 2004, 28(3):186-194. https://doi.org/10.1207/s15324796abm2803_7