Q. I am a 42-year-old man. I have high blood pressure, am overweight and smoke.

My father had a heart attack in his 50s, so I am quite concerned about my health.

I would like to start doing regular exercise to help me lose weight and get fitter. My friends have asked me to join them for a half marathon.

Are there any special precautions I need to take note of? I get slightly breathless when I walk a bit faster.

A. It is good that you want to take up regular exercise.

It will help you feel fitter and stronger. It also has many health benefits, including reducing the risk of a heart attack and certain types of cancers.

However, you should also quit smoking and ensure that your blood pressure is well controlled.

Before starting on an exercise programme, you should check if you have any physical impairment to performing physical activity, such as bone, joint, visual, heart or lung problems.

You should not have any unexplained symptoms or discomfort.

The slight breathlessness you complain of also needs to be checked.

Consult a doctor to get assessed for any other symptoms, such as chest discomfort, palpitations, dizziness or fainting.

Depending on the findings, you may be referred to a cardiologist.

The cardiologist may then decide on further tests to rule out any underlying heart disorders, such as coronary artery or heart valve disorders, which are more easily managed if they are detected early.

If you are planning to do a vigorous activity, such as a marathon, for the first time and had previously led a sedentary lifestyle, a treadmill exercise test should be considered.

This test can screen for heart disease, determine your fitness level and establish your appropriate training heart rate.

Alternatively, for the more serious sports enthusiasts, a specialised cardiopulmonary exercise test may be performed.

This can help to determine your optimal heart rate for endurance sports. It can also customise training programmes to improve performance, as well as detect any underlying heart, lung or circulatory problems.

Even after you have been given the all-clear to exercise, you should begin your exercise regimen slowly and build it up gradually. This is the safest way to go.

Do check your blood pressure (BP) regularly before doing any exercise and take note of the readings.

Consult your doctor if your resting BP readings are persistently greater than 140/90mmHg.

You may have to hold off doing more intense activities, in particular resistance or weight training, until your BP is better controlled.

If you are planning to join a marathon, ensure that you have done adequate preparation beforehand.

This means regular training and paying attention to nutrition and hydration.

Start with running 5km to 10km, before progressing to longer distances.

Alternatively, you can consider joining a preventive therapy programme supervised by a cardiologist experienced in preventive and exercise medicine.

This programme provides the individual with supervision and advice on lifestyle choices, customised therapeutic exercises and nutrition prescriptions.

It will help you to manage your hypertension, achieve better weight control and reduce your risk of heart disease and cancer.

Good health and wellness cannot be taken for granted, but must be cultivated with the same dedication as other important aspects of our lives, such as family and job.

Just as we build up a financial retirement nest egg to enjoy in our golden years, we must pay equal, if not more, attention to investing in our future health and independence.

Senior consultant cardiologist at The Harley Street Heart & Cancer Centre

Dr Peter Ting