Regular exercise has long been recognized as one of the most effective ways to protect the heart. Now, a new scientific statement from the American College of Cardiology (ACC) emphasizes that physical activity should be an essential part of preventing and managing cardiovascular disease — much like medications, blood pressure monitoring and other established treatments.
Published recently in the Journal of the American College of Cardiology, the 2026 statement, Exercise Prescriptions for Cardiovascular Health in Adults, provides guidance on tailoring exercise to patients’ health conditions, fitness levels and individual needs.
One central message is that even modest increases in physical activity can produce meaningful cardiovascular benefits, particularly among people who are currently inactive.
“The most important message is that you don’t have to become an athlete to improve your heart health,” says Christina Michael, M.D., cardiologist and medical director of the Echo Lab with Baptist Health Heart & Vascular Care at Bethesda Hospital East. “For someone who spends most of the day sitting, simply beginning to walk regularly can make a meaningful difference. The goal is to establish a routine that becomes part of everyday life.”
How Much Exercise Is Enough?
The ACC reinforces established recommendations that adults should aim for at least 150 minutes of moderate-intensity aerobic activity weekly or 75 minutes of vigorous activity. Moderate activities include brisk walking, recreational cycling and swimming. Vigorous activities, such as running or faster cycling, require greater effort and heavier breathing.
For additional benefits, adults can work toward 300 minutes of moderate activity or 150 minutes of vigorous activity weekly.
The ACC states that it “provides a comprehensive overview of activity targets for patients across the spectrum of cardiovascular disease, including the role of functional testing, wearable devices to encourage activity, and practical strategies for increasing patient participation in independent physical activity as well as programs such as cardiac rehabilitation.”
However, the ACC emphasizes that these targets should not discourage people who struggle to meet them. The greatest reduction in cardiovascular risk occurs when someone moves from being inactive to doing even a small amount of exercise.
“The cardiovascular benefits of exercise are not all-or-nothing,” explains Tarak Rambhatla, M.D., cardiologist at Baptist Health Miami Cardiac & Vascular Institute. “Patients sometimes believe that if they cannot exercise for 30 or 45 minutes, there is little benefit in doing anything. But shorter periods of activity throughout the day can add up, especially for people who are just getting started.”
The ACC also recognizes that people who concentrate their weekly exercise into one or two days — sometimes called “weekend warriors” — can experience cardiovascular benefits comparable to those who spread activity throughout the week.
“For someone who is relatively inactive, increasing from 2,000 to 4,000 steps a day may be a more realistic starting point than immediately aiming for 10,000. The key is gradual progress. Walking is accessible to most people, requires little equipment and can be adjusted to an individual’s physical abilities.”
Christina Michael, M.D., cardiologist and medical director of the Echo Lab with Baptist Health Heart & Vascular Care at Bethesda Hospital East.
Walking: You Don’t Necessarily Need 10,000 Steps
For years, 10,000 daily steps has been a widely promoted fitness goal. The ACC highlights research suggesting that substantially fewer steps can improve cardiovascular health.
One analysis involving more than 111,000 participants found that walking approximately 2,500 to 2,700 steps daily was associated with lower risks of death and cardiovascular events, respectively. Another analysis of 51 studies found that people averaging 7,000 steps daily had a 47 percent lower risk of death from any cause and cardiovascular disease compared with those averaging 2,000 steps.
These observational findings do not establish that walking alone caused the reductions, but they reinforce the relationship between movement and better health.
The ACC identifies approximately 7,000 daily steps as a practical target for many adults, while recognizing that even lower amounts are beneficial.
“For someone who is relatively inactive, increasing from 2,000 to 4,000 steps a day may be a more realistic starting point than immediately aiming for 10,000,” says Dr. Michael. “The key is gradual progress. Walking is accessible to most people, requires little equipment and can be adjusted to an individual’s physical abilities.”
Strength Training Is Also Important
Aerobic exercise receives considerable attention for its cardiovascular benefits, but the ACC emphasizes that resistance training should also be part of a comprehensive exercise program.
Resistance training involves working muscles against resistance, such as weights, exercise bands or body weight. Adults are encouraged to perform muscle-strengthening activities at least twice weekly, targeting major muscle groups.
Strength training can improve blood pressure, blood sugar regulation, muscle strength and body composition — the proportion of fat and muscle in the body. It also helps preserve muscle mass, improve balance and maintain independence with aging.
The ACC notes that combining resistance training with aerobic activity may provide greater overall health benefits than relying on either approach alone.
“Exercise helps improve how blood vessels function and how efficiently the cardiovascular system responds to physical demands. Even modest reductions in blood pressure can be important over time, particularly when combined with other measures such as a healthy diet, appropriate medications and regular monitoring.”
Tarak Rambhatla, M.D., cardiologist at Baptist Health Miami Cardiac & Vascular Institute.
Exercise Can Help Lower Blood Pressure
The statement highlights evidence that regular exercise can produce measurable reductions in blood pressure, an important risk factor for heart attack, stroke and kidney disease.
A review of 31 randomized clinical trials involving 1,345 adults with hypertension, or high blood pressure, found improvements across several exercise approaches.
Average reductions included:
- Aerobic exercise: Approximately 4.7 points in systolic blood pressure and 2.8 points in diastolic pressure.
- High-intensity interval training: Approximately 5.7 and 4.6 points, respectively.
- Combined aerobic and resistance training: Approximately 6.2 and 3.9 points, respectively.
Systolic pressure is the top number in a blood pressure reading, while diastolic pressure is the bottom number.
“Exercise helps improve how blood vessels function and how efficiently the cardiovascular system responds to physical demands,” says Dr. Rambhatla. “Even modest reductions in blood pressure can be important over time, particularly when combined with other measures such as a healthy diet, appropriate medications and regular monitoring.”
Exercise should complement, rather than automatically replace, prescribed blood pressure medications.
The ACC advises against exercising when resting systolic blood pressure (the top number) exceeds 200 mm Hg or diastolic pressure exceeds 110 mm Hg, until medically evaluated.
Exercise for People Already Living With Heart Disease
Physical activity is not only important for prevention. It can also improve outcomes among people who have already experienced heart problems.
The ACC strongly supports cardiac rehabilitation, a medically supervised program combining exercise, education and cardiovascular risk management.
These programs are recommended for eligible patients recovering from heart attacks, coronary artery procedures or heart surgery, as well as certain people with stable heart disease.
For patients with heart failure, a condition in which the heart cannot pump blood efficiently enough to meet the body’s needs, appropriately supervised exercise can improve endurance and quality of life.
The ACC also recommends structured walking programs for people with peripheral artery disease, which occurs when narrowed arteries reduce blood flow to the legs.
“Having cardiovascular disease does not automatically mean a person should avoid exercise,” says Dr. Michael. “In many cases, appropriately prescribed physical activity is an important part of treatment. What matters is understanding the patient’s condition, symptoms and limitations so that exercise can be performed safely.”
Exercise Benefits Go Beyond Weight Loss
The ACC emphasizes that exercise benefits should not be measured solely by changes on the scale.
Physical activity improves cardiovascular fitness, blood pressure, blood sugar control and overall health, even when weight loss is limited. For people with overweight or obesity, combining exercise with dietary changes generally produces greater weight loss than exercise alone.
Resistance training is particularly important during weight loss because it helps preserve muscle mass. This may be especially relevant for people using GLP-1 medications for weight management or recovering from bariatric surgery.
The statement also encourages older adults to incorporate balance, flexibility and strength exercises to maintain mobility and reduce fall risks.
Can Smartwatches and Fitness Trackers Help?
Wearable technology, including smartwatches and step counters, may help people become more active by providing feedback and encouraging goal setting.
The ACC cites research showing that activity trackers increased walking by approximately 1,850 steps daily among healthy adults.
Among people with cardiometabolic conditions, including cardiovascular and metabolic diseases, wearable-based interventions increased daily steps by approximately 2,600 and moderate-to-vigorous activity by 36 minutes weekly.
However, the benefits vary, and some users stop wearing their devices over time. The ACC emphasizes that trackers work best when combined with personalized goals and professional guidance.
Starting Safely and Building a Lasting Routine
The ACC states that most adults without symptoms or unstable cardiovascular conditions do not require routine exercise stress testing before becoming physically active.
However, people with certain heart conditions, unexplained symptoms or plans to begin vigorous exercise may need medical evaluation.
New chest discomfort, unusual breathlessness, dizziness or other concerning symptoms during exercise should prompt stopping activity and seeking medical attention. Severe or persistent symptoms warrant emergency evaluation.
The statement also warns that prolonged sitting carries cardiovascular risks that may not be completely offset by meeting weekly exercise targets. Moving periodically throughout the day remains important.
“Exercise should be viewed as a long-term investment in cardiovascular health, not a short-term fitness challenge,” says Dr. Rambhatla. “The best program is one that patients can maintain consistently, whether that means walking, swimming, cycling or strength training. Over time, those habits can make a meaningful difference in heart health and quality of life.”
Ultimately, the ACC’s message is that exercise should be considered a routine component of cardiovascular healthcare, not simply an optional lifestyle recommendation. For people who are currently inactive, the most important step may be getting started.
Source: baptisthealth.net
