Lung health and heart health are tightly linked. One organ – lungs – absorb all blood that the heart pumps out. It is equal to entire body blood vessels! Lung health advice from a top expert in pulmonary hypertension and heart failure. Lungs are the only human organ that receives the entire volume of blood that the heart pumps out with every heartbeat, with every ejection. This is a very important question. How to keep lungs healthy? Dr. Anton Titov, MD. Is there a "lung training protocol" to optimize lung function? Dr. Anton Titov, MD. Obviously, not smoking is an important part to keep lungs healthy. But could we go beyond not smoking advice? Dr. Anton Titov, MD. Because there are many people who don't smoke. They are interested to know how to keep lungs healthy all your life. Dr. Aaron Waxman, MD. Lung health is connected with cardiovascular health and total body health. One of the unique features of the lung is that it does take the entire cardiac output. The left heart has the opportunity to pump out blood to the entire body. We have to think about the complexity of the lung circulation. Dr. Aaron Waxman, MD. Lung has to accommodate all that blood supply. Think about the transition from rest to exercise. At rest we are pumping about 4.5 liters of blood per minute. So the lung vessels just have to accommodate that. Now you start to do exercise. If you are a strong athlete, you may increase that cardiac output to 15 to 20 liters per minute. All those blood vessels in the lung have to open up and accommodate more blood. The lung has a huge reserve of vessels that it can recruit. Lungs can open and accommodate increased blood flow from the heart without any trouble. Dr. Aaron Waxman, MD. We see in the normal person that the pulmonary vascular resistance will go down dramatically during physical exercise. Cardiac output increases during exercise and lung vascular resistance decreases. But in the patient with lung disease, we run into trouble, especially with right-sided heart function. Because blood vessels in a lung are not able to accommodate all blood flow from the heart. But even in patients with lung disease, exercise is a huge bonus to the lung. The more you exercise, the better is your lung fitness. Dr. Anton Titov, MD. You also get better cardiac fitness, of course. The lung learns how to adapt to increased blood flow from the heart during exercise. Lungs can recruit those blood vessels better as you train. That also brings up the whole issue of blood perfusion to the muscles. The more you exercise, the better the perfusion of the muscles. This is true especially at the micro circulatory level. That means you have more mitochondria. It means more energy production. Body physiology starts to match itself and accommodate and adapt to whatever the patient’s disease. Dr. Aaron Waxman, MD. We promote exercise for all of our patients. Is there any particular strategy apart from exercise to keep lungs healthy? Dr. Anton Titov, MD. Maybe a lifestyle and perhaps dietary or even chemopreventive strategy for lung disease prevention? Dr. Anton Titov, MD. Obviously, the environment is very important. There is only so much we can do with environment. But certainly staying away from smoking is important. Staying away from things that are not healthy in the air. Dr. Aaron Waxman, MD. But again, it is hard to control environment. But a balanced nutritional approach to lifestyle is always good. There are all different kinds of diets people use. But as long as it is a well balanced and not excessive diet, then it is good. From an exercise standpoint, a combination of aerobic conditioning along with some simple strength training makes people feel a whole lot better. They are able to do a lot more with their lungs.