Most people have heard the advice to move more, but hearing it in passing is different from receiving a plan. A new scientific statement from the American College of Cardiology argues that exercise deserves the same deliberate treatment as a medication, with a tailored dose for each patient.
In this article we will discuss what the statement says, what it leaves out on purpose, how it treats fitness, daily steps, cardiac rehabilitation, testing and wearable devices, and how an ordinary reader can use it to start safely.
Exercise Moves From Advice to Prescription
On October 15, 2026, the American College of Cardiology published a scientific statement titled “Exercise Prescriptions for Cardiovascular Health in Adults” in JACC. News-Medical reported on it the same week. The central message is that exercise should be treated as a foundational part of both preventing and treating cardiovascular disease, rather than as a pleasant extra that comes after the real medical care is finished.
That framing is the news. Cardiologists have long known that physical activity helps the heart, and nobody who follows medicine will be surprised that the college endorses it. What changes is the posture: the statement asks clinicians to prescribe exercise deliberately, to individualize it, and to build it into routine visits the way blood pressure checks and cholesterol discussions already are. A prescription implies a specific recommendation, a follow-up and some accountability, all of which “try to walk more” lacks.
The statement was written by a committee chaired by Jonathan N. Myers, PhD, of the Palo Alto VA Healthcare System. In the coverage, he calls exercise “one of the most effective therapies available for preventing and managing CVD,” a line that sums up the document’s tone. Strong language from a professional society is not unusual, but it carries weight here because it asks health systems to act, not just individuals to try harder. That shift in responsibility is easy to miss and is arguably the most important thing about the document.
It also helps to be clear about what kind of document this is. A scientific statement is a review and synthesis of the evidence, with guidance for practice, written by a group of experts. It is not a law, it is not an insurance rule, and it is not a personal medical order. Whether your own clinician adopts its approach, and how, depends on your health, your history and the resources available where you live.
Why would a professional society bother? Part of the answer is that advice without structure tends to evaporate. A patient who leaves a short appointment with a vague suggestion to be more active has little to hold onto, whereas a patient who leaves with a defined plan, a reason, and a date for review has a project. The statement’s authors appear to be betting that treating exercise like other therapies, with a starting point, adjustments and follow-up, will change what in practice happens after the visit ends.
It is also worth noting who this affects. The statement is about adults, and it spans prevention in people without known disease as well as treatment in people who already have it. That breadth means the message is relevant to a healthy fifty-year-old with a desk job, to someone managing high blood pressure, and to a person years past a cardiac event. The details of the plan differ, but the underlying principle is the same.
Core Recommendations in the Statement
The reporting on the statement lists several connected points. Taken together they describe a model of care that is personalized, supported and woven into everyday medicine. The table below condenses them, and the sections that follow unpack the ones that matter most for readers.
| Theme | What the statement says |
| Role of exercise | A foundational part of cardiovascular disease prevention and treatment |
| Personalization | Tailored to condition, functional capacity, symptoms, goals and preferences |
| Types of exercise | Resistance training should complement aerobic exercise for most adults |
| Technology | Wearables and virtual or home-based rehab may support adherence, especially alongside structured programs |
| Testing | Routine exercise testing is not required before starting for most asymptomatic or clinically stable people, |
| though it can inform prescriptions when appropriate | |
| Cardiac rehab | First-line for many patients with cardiovascular disease, and access should be expanded |
| Patients outside rehab | People with known disease who cannot join a formal program should still receive an individualized prescription |
| Routine care | Exercise counseling should be integrated more fully into regular visits |
| Who benefits most | The greatest risk reduction occurs when sedentary people become even modestly more active |
Reading the table as a whole, a pattern emerges. Nothing in it asks for heroics. The recommendations stress meeting people where they are, lowering the barriers to starting, and keeping the supports in place so that people stay with it. That is a sensible design for a recommendation, because the biggest threat to any exercise plan is not a lack of knowledge but the gap between intention and routine.
Personalization is the Point
The most practical idea in the table is that one size does not fit all. A person recovering from a heart attack, a person with high blood pressure who has never exercised, and a person with stable disease who already walks daily have different starting points, symptoms and goals. A good prescription takes into account what the person can do now, what they want to do, and what they will really keep doing.
Preferences get named explicitly, and that deserves emphasis. A plan that ignores whether you like swimming, hate gyms or have a dog that needs walking is a plan that will be abandoned by March. The statement’s emphasis on goals and preferences is an acknowledgment that the best exercise is the one a person sustains.
Resistance Training Joins Aerobic Activity
The statement says resistance training should complement aerobic exercise for most adults. In plain language, that means activities that work the muscles against a load, such as weights, bands or body weight exercises, belong alongside the walking, cycling or swimming that most people think of first. The coverage we have does not provide specific amounts, intensities or routines, and we will not invent any.
Many adults skip strength work because it seems intimidating or because they associate it with bodybuilding, so the statement’s wording is a useful nudge: for most adults, strength is part of the plan, not a bonus for the already fit. The existing national physical activity guidelines in the United States and your own clinician are the right places to get those details.
Fitness as a Risk Factor
One of the more striking claims in the statement concerns cardiorespiratory fitness, a measure of how well your heart, lungs and muscles work together to deliver oxygen during sustained activity. According to the reporting, low fitness predicts future cardiovascular disease about as strongly as smoking, high blood pressure, high cholesterol and diabetes. Those four are the risk factors patients hear about most often, so seeing fitness stand alongside them reframes how we think about the problem.
For most people, the risk factors on that list prompt action. Smokers are told to quit, patients with high blood pressure get medication or lifestyle advice, and those with elevated cholesterol or diabetes receive monitoring and treatment. Low fitness rarely gets the same treatment in the exam room, and the statement implies it should. If fitness predicts disease about as well as those conditions do, then it deserves to be asked about, measured when appropriate and treated.
A practical consequence is that fitness could become a number your clinician asks about, the way they ask about smoking. Whether that happens in your clinic depends on local practice, and the statement itself is guidance, not a mandate. But as a patient you can raise it yourself: ask how your fitness compares with what would be expected for your age and health, and what a realistic improvement looks like.
What Fitness Means in Everyday Terms
You do not need a laboratory to get a rough sense of it. If climbing a couple of flights of stairs leaves you winded, or a brisk walk is out of reach, that is information worth sharing with your clinician. Fitness is also not fixed. It responds to training at nearly any age, which is the encouraging half of the finding.
The Encouraging Half of the Finding
The statement says the greatest reduction in risk occurs when sedentary people become even modestly more active. This is a point about where the biggest gains sit. The jump from doing nothing to doing something is larger than the jump from doing something to doing a lot. That is good news for anyone who feels it is too late or that the goal is too far away.
Steps, Not Marathons
Many readers will take away a number, and the statement offers one in the form of daily steps. According to the reporting, benefits are achievable with fewer than 10,000 steps a day, and roughly 5,000 to 7,000 steps a day are associated with clinically important improvements and substantial reductions in cardiovascular and all-cause mortality for many adults. That range is more modest than the famous 10,000 target that fitness trackers have popularized for years.
The phrase “associated with” matters. Step counts and health outcomes were observed together in studies, and people who walk more also differ from people who walk less in other ways, including baseline health. The statement describes an association, not a guarantee, and no step count promises protection from heart disease. Still, a consistent pattern across many adults is useful evidence for setting a realistic goal.
Why a Lower Target is Useful
A target that feels attainable is more likely to be pursued. Someone with a mostly sedentary routine who is told to reach 10,000 may feel defeated at the outset. Someone told that 5,000 to 7,000 is associated with substantial benefit has a destination that fits a normal day with a short walk after meals, a few trips up and down the stairs, and some errands on foot. If you already exceed that range, the statement does not tell you to stop; it simply says you do not need to chase a perfect number.
There is a quieter benefit in a lower target, too: it respects the reality that people differ. A parent with a physical job may log many steps without any deliberate exercise, while a person with arthritis or limited mobility may find even a modest total demanding. The statement’s emphasis on individualization applies here, since a number that suits a healthy forty-year-old may be wrong for an older adult or someone with symptoms.
Using a Step Count Wisely
A step counter is a feedback tool, not a verdict. Start by learning your typical daily average over a week without changing anything, then raise it gradually. Keep in mind that steps do not capture swimming, cycling or lifting, and so a day of strength training with a low step count is not a failure. If you have a heart condition, symptoms or a history of events, ask your clinician what level is appropriate for you instead of picking one from a headline.
Dr. Myers put the philosophy this way: “The most important message is that some activity is better than none.” He also said, “Patients do not need to become athletes to improve their cardiovascular health.” Those two sentences are the most useful ones in the coverage for someone standing at the starting line.
Cardiac Rehabilitation and Access
The statement describes cardiac rehabilitation as a first-line option for many patients with cardiovascular disease, and calls for expanding access to it. Cardiac rehab is a supervised program that combines monitored exercise, education and support, usually delivered through a hospital or clinic after an event or procedure or for certain chronic conditions. It is not a gym membership; it is medical care that happens to involve movement.
Calling it first-line signals that it should be the default consideration, not a rare referral. The call to expand access acknowledges a practical problem: even when a program exists, patients may live far from it, may not be referred, or may struggle with the schedule and the cost. The statement’s broader message is that those barriers are system problems, not personal failings.
Readers sometimes assume cardiac rehab is only for people who have had a heart attack. The statement’s wording is broader, describing it as first-line for many patients with cardiovascular disease, and which patients qualify depends on diagnosis, your clinician’s judgment and, in practice, your coverage. If you have never been offered a referral and think you might benefit, asking costs nothing.
If You Cannot Join a Formal Program
The statement is clear that patients with known cardiovascular disease who cannot join formal rehab should still receive an individualized exercise prescription. That matters for people in rural areas, people with transportation or work constraints, and those whose insurance or local services make participation difficult. Being unable to attend a program is not a reason to go without guidance. A well-written home plan should say what to do, how often to review it, which symptoms mean stop, and whom to call. If that describes you, ask your cardiologist or primary care clinician what a safe home-based plan would look like, and who will check in on it.
The expansion of access is not only about buildings. Virtual and home-based approaches are one way the statement envisions reaching more people, and they pair naturally with the call for individualized prescriptions for those who cannot attend in person. For a patient, the questions to ask are simple: who is supervising my plan, how will they know if I have a problem, and what should I do if I notice symptoms?
Technology as Support, Not Replacement
The statement says wearables and virtual or home-based rehab may support adherence, especially alongside structured programs like cardiac rehab. The word “may” is doing honest work there. Technology can remind, track and motivate, and remote options can reach people who cannot travel, but the statement positions these tools as supports, best used in combination with structured care. A watch that counts your steps will not replace a clinician who adjusts a plan after a symptom.
Testing, Wearables and Home Programs
One of the more practical lines concerns exercise testing. According to the statement, routine exercise testing is not required before starting for most asymptomatic or clinically stable people, although it can inform the prescription when appropriate. Asymptomatic means without symptoms, and clinically stable means a known condition that is not changing or worsening.
This addresses a common barrier. Some people delay getting started because they assume they need a stress test or a full workup first. For most people described above, the statement says that is not a requirement. It does not say testing is useless or never needed, and it keeps the door open for cases where the results would help shape the plan.
For readers who have been told they are fine to be active, the practical message is liberating: you can begin with low-intensity activity such as walking without first scheduling a battery of tests. For readers who have symptoms, a heart condition or doubts, the message is equally clear, because the statement ties testing to appropriateness, and a conversation with the clinician is how appropriateness gets decided.
When to Talk to a Clinician First
Nothing here means you should ignore warning signs. New or unexplained chest discomfort, shortness of breath out of proportion to effort, dizziness, fainting or a racing heartbeat during activity are reasons to stop and seek medical advice, and in an emergency to call for urgent care. If you have known heart disease, have had a recent cardiac event or take medicines that affect your heart rate or blood pressure, talk with your clinician before you change your routine. The statement’s logic is that most stable people do not need extra hurdles, and the clinician is the one who decides whether you are in that group.
Choosing and Using a Wearable
If you wear a fitness tracker, use it for what it does well: trend data. Looking at your weekly average of steps, the regularity of your activity and the way your resting numbers change over months is more informative than any single day’s reading. Device accuracy varies, and an occasional odd number is not a reason for alarm. If a device alerts you to something concerning, take it to a clinician rather than relying on the device alone to interpret it.
Final Thoughts: A Practical Way to Begin
Turning a statement into a habit takes small, deliberate steps. The following order is a sensible way to approach it, built on what the statement says and on ordinary common sense. It is general information, and a clinician who knows you can adjust it.
Step One: Bring it Up at Your Next Visit
Ask your primary care clinician or cardiologist whether they can give you an individualized exercise prescription. Mention your conditions, your symptoms, your goals and what you enjoy. If you have known cardiovascular disease, ask directly whether cardiac rehabilitation is appropriate for you and, if it is not available nearby, what the alternative is. The statement says counseling should be integrated into routine care, so this is a reasonable request, not an unusual one.
Step Two: Pick a Baseline and a Small First Goal
Measure what you do now for a week. Then aim for a modest increase, not a leap, because the statement notes that the largest gains come when sedentary people become even a little more active. Choose a form of activity you can see yourself doing in six months, whether that is walking with a neighbor, an evening loop around the block, or a class that makes the time pass quickly.
Step Three: Add Strength Work When You are Ready
Because resistance training is meant to complement aerobic exercise for most adults, plan to add some once the walking habit is steady. For amounts and technique, rely on national physical activity guidelines and on your clinician or a qualified trainer, since the statement coverage here does not spell them out. Start light, focus on form and let your clinician know about any joint, balance or heart concerns.
One more tip for the first month: attach the new activity to something you already do. A walk after dinner, a stretch while the coffee brews or a set of simple strength moves before the evening news is easier to sustain than a new commitment that needs its own slot in the calendar. Habits form around cues, and an existing routine provides a cue for free.
Step Four: Track, Adjust and Keep it Social
Use a step counter or a simple calendar to see progress, and review the plan with your clinician after a few weeks. Exercising with another person makes it easier to show up. If you miss a week, restart without drama; the statement’s own message is that some activity beats none, and a restart is activity.
A final note on expectations: progress is rarely a straight line. Illness, travel, work deadlines and bad weather will interrupt any plan, and the point of an individualized prescription is that it can bend. Tell your clinician what got in the way, since that information is useful for redesigning the plan, and treat a setback as data rather than as failure. People who keep returning to some level of activity, even a small one, are doing what the statement asks.
If cost or access is the obstacle, mention that too. Clinicians often know about community programs, walking groups and low-cost options that never appear in a patient handout, and they can help you choose between them. This is general information, and your own clinician can tailor it to your health.
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Frequently Asked Questions
What did the American College of Cardiology say about exercise?
In a scientific statement published in JACC on October 15, 2026, the college said exercise should be prescribed as a foundational part of preventing and treating cardiovascular disease. It should be individualized, with resistance training complementing aerobic exercise for most adults. It also called for expanded access to cardiac rehabilitation.
How many steps a day are good for your heart?
According to the reporting, benefits are achievable with fewer than 10,000 steps a day, and roughly 5,000 to 7,000 steps are associated with clinically important improvements for many adults. This is an association, not a guarantee. Ask your clinician what is right for you.
Do I need a stress test before I start exercising?
The statement says routine exercise testing is not required before starting for most asymptomatic or clinically stable people. It can help shape a prescription when appropriate. If you have symptoms or known heart disease, talk with your clinician first.
Is cardiac rehab better than exercising on my own?
The statement calls cardiac rehabilitation first-line for many patients with cardiovascular disease. People who cannot join a formal program should still get an individualized prescription. Your cardiologist can tell you which route suits you.
Does low fitness really raise heart disease risk?
According to the reporting on the statement, low cardiorespiratory fitness predicts future cardiovascular disease about as strongly as smoking, high blood pressure, high cholesterol and diabetes. The good news is that fitness can improve with regular activity. The greatest gains come when sedentary people become even modestly more active.
Can a fitness tracker replace cardiac rehab?
No. The statement says wearables and virtual or home-based rehab may support adherence, especially alongside structured programs like cardiac rehabilitation. They are supports, not substitutes for supervised care when it is recommended.
