Before beginning any exercise program, individuals should get a complete physical examination and discuss any fitness plans with a physician. A physician will be able to help formulate a fitness program based on an individual's age and health status or, at the least, recommend a suitable fitness trainer. The physician may also order an exercise stress test, which can help determine a safe level of exercise for individual needs. 

According to the American Heart Association, certain individuals are especially urged to seek medical advice before beginning a program, including those who:

• Have reached or passed middle age.
  
  
• Are significantly overweight or obese.
  
  
• Have a family history of heart disease
  
  
• Want to begin a fairly strenuous exercise program but have been inactive for quite some time.
  
  
• Are taking medication for high blood pressure (hypertension), heart disease or stroke.
  
  
• Have any joint problems (e.g., arthritis), bone problems (e.g., osteoporosis), muscle problems or other conditions (e.g., unstable heart failure) that may be worsened or complicated by exercise.
  
  
• Have noticed new symptoms in the past month (e.g., chest pain).
  
  
• Have been ordered by a physician to engage only in medically supervised exercise programs.
  
  
• Exhibit any of the following symptoms: severe shortness of breath, fainting (syncope), or pain in the chest, arm, shoulder or left side of the neck after participating in mild exercise

To make the most of aerobic exercise, it is important for people to exercise within 70 to 80 percent of their maximum heart rate. Exercising within this range is one’s target heart rate (THR). To calculate your target heart rate, use the following formula:

• Maximum heart rate (MHR) = 220 – your age. For example, the MHR of a 50-year-old would be 170 (220 – 50).
  
  
• Your MHR multiplied by 0.7 is the low range of your target heart rate. For example, a 50-year-old should reach or exceed a heart rate of 119 (170 x 0.7).
  
  
• Your MHR multiplied by 0.8 is the high range of your target heart rate. For example, a 50-year-old should not exceed a heart rate of 136 (170 x 0.8).

The THR is the pulse rate at which exercise “counts.” With your physician, you can also identify warm-up exercises appropriate for reaching this target rate. Typically, 30 minutes of exercise at your THR is adequate for cardiovascular benefit. Most experts recommend participating in an aerobic exercise at least three days a week. Other experts believe that shorter workouts (e.g., 10 minutes) every day are also effective. Studies have shown that even walking for a period every day can help lower your risk of medical conditions.

While exercising, people are encouraged to monitor their heart rate regularly to make sure that they are staying within the appropriate range for their age.

Many exercise machines (e.g., treadmills, stationary bicycles) provide a heart monitor to help people remain within their target heart rate. If a computerized monitor is not available, individuals may try using a simple "talk test." During moderate exercise, it should be possible to carry on a normal conversation comfortably.

If people are gasping and unable to talk, they have probably reached or exceeded their optimum aerobic zone. At any time, if exercisers feel chest pain (angina) or shortness of breath, they should stop exercising immediately and consult their healthcare provider.

There are certain strategies that should be undertaken as part of any exercise program in order to be safe. These include:

• Warming up and cooling down. Regardless of the type of exercise performed, it is necessary to prepare for the workout by gradually increasing the heart rate (warming up), exercising at an increased heart rate for a given period of time (working out) and gradually decreasing the heart rate until it nears the resting rate (cooling down). This places less stress on the heart and muscles.
  
  
• Stretching before and after exercise. This is the key to a good exercise program. Before exercise, use lighter weights than normal and jog in place slowly or perform other light but full-movement activities, as the goal is to begin speeding up the heart rate. After exercise, however, the goal is to decrease the heart rate. Slow stretches, which focus on movement of particular muscles or body regions, will allow you to “wind down.” Older people are encouraged to take extra time in warming up and cooling down.
  
  
• Not trying to do too much too fast. Overexerting yourself can lead to injury and a much lower chance that you will continue to exercise in the future. When starting an exercise program, take it easy at the beginning and work up to a level where you feel comfortable. Wear appropriate clothes and shoes. Clothes should be loose-fitting, and shoes should fit  properly. For example, people should not be hiking up a mountain in flat shoes that offer no support. People with diabetes are urged to take especially good care of their feet, wearing clean and supportive shoes and socks and checking their feet after exercise for any sign of redness or injury.
  
  
• Drinking plenty of water. This tip is particularly important for people who are exercising in hot climates or who are taking medications that stress the need for plenty of water. Diabetic individuals should also have a light, sugary snack on hand in case they begin to feel light-headed or notice other symptoms of hypoglycemia.
  
  
• Having proper identification on hand. If you wear a medical identification bracelet or tag, you should always have it on while exercising.  When exercising away from home, it is also a good idea to carry your physician’s address and phone number (as well as your own contact information) in case of emergency.