Many people think of exercise as something they should do to lose weight or stay fit. However, doctors are increasingly viewing physical activity as a powerful form of medicine.
A new scientific statement from the American Heart Association (AHA) encourages healthcare providers to prescribe exercise for healthy adults who have slightly high blood pressure or mildly raised cholesterol before turning to medications.
This recommendation is based on growing evidence that regular physical activity can improve heart health and reduce the risk of future disease.
For many people, becoming more active may be enough to bring blood pressure and cholesterol closer to healthy levels, especially when combined with other healthy lifestyle changes.
High blood pressure, also called hypertension, happens when blood pushes too strongly against the walls of the arteries.
Over time, this extra pressure can damage blood vessels and increase the risk of heart attacks, strokes, kidney disease, and heart failure.
High cholesterol is another major risk factor for heart disease. Low-density lipoprotein (LDL), often called “bad” cholesterol, can build up inside arteries and make it harder for blood to flow.
Millions of adults have mildly raised blood pressure or cholesterol without realizing it because these conditions usually cause no obvious symptoms. This is why regular health check-ups are so important.
According to the American Heart Association, around 53 million adults in the United States have slightly elevated blood pressure.
This usually means a systolic blood pressure, the top number in a blood pressure reading, between 120 and 139 millimeters of mercury (mmHg), or a diastolic blood pressure, the bottom number, between 80 and 89 mmHg. Around 71 million adults also have mildly elevated LDL cholesterol levels.
Current medical guidelines recommend that people with mild increases who do not have a high risk of heart attack or stroke should first focus on improving their lifestyle. The AHA says physical activity should be one of the most important parts of this plan.
The organization encourages doctors to talk with patients about their daily activity levels during routine appointments. Instead of simply telling patients to “exercise more,” doctors are encouraged to write personalized exercise prescriptions. These plans should match each person’s age, fitness level, interests, and health conditions, making it easier for people to stick with them over time.
For some people, an exercise prescription may simply involve walking for 30 minutes most days of the week. Others may enjoy cycling, swimming, dancing, gardening, or playing sports. The best exercise is often the one people enjoy enough to continue doing regularly.
Doctors may also recommend simple ways to move more throughout the day. Walking instead of driving short distances, taking the stairs instead of the elevator, parking farther from store entrances, or joining a local fitness class can all increase daily physical activity.
Research shows these small changes can produce meaningful health benefits. Regular exercise can lower systolic blood pressure by about 3 to 4 mmHg and reduce LDL cholesterol by around 3 to 6 milligrams per deciliter. While these improvements may seem modest, even small reductions can lower the risk of future heart disease.
People who stay physically active also have about a 21% lower risk of developing cardiovascular disease and a 36% lower risk of dying from heart-related conditions compared with people who are inactive.
Federal health guidelines recommend that adults aim for at least 150 minutes of moderate-intensity aerobic exercise each week, such as brisk walking, cycling, or swimming. Another option is at least 75 minutes of vigorous activity, such as running or fast cycling. Adults should also perform muscle-strengthening exercises at least two days each week to help maintain strength, balance, and overall health.
The AHA stresses that people do not have to reach these goals immediately. Adding just five or ten extra minutes of movement each day is a good starting point. Gradually increasing activity over time is often more successful than trying to make dramatic changes all at once.
Exercise works best when combined with other healthy habits, including eating a balanced diet, maintaining a healthy body weight, avoiding smoking, limiting alcohol, managing stress, and getting enough sleep.
The scientific statement was led by Bethany Barone Gibbs and published in the journal Hypertension. The authors hope that making exercise a routine part of medical care will help many people control mild blood pressure and cholesterol problems naturally, reducing the need for medication and lowering the risk of serious heart disease in the future.
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