Physical activity is one of the most accessible and cost-effective strategies for improving cardiovascular health. Current guidelines recommend that healthy adults engage in at least 150–300 minutes of moderate-intensity or 75–150 minutes of vigorous-intensity aerobic activity per week, or an equivalent combination, supplemented by muscle-strengthening activities on at least two days. However, systematic mechanistic elucidation and precise guidance regarding the specific associations of different exercise modalities and doses with cardiovascular health remain lacking. So, Fangchao Liu and colleagues set out to do so.
The review indicates a non-linear dose-response relationship between aerobic exercise duration and cardiovascular disease risk, with significant risk reduction observed across the entire range, and greater benefits for inactive populations. Objectively measured physical activity information suggests that performing aerobic exercise in the evening may yield greater health benefits; for individuals unable to maintain a daily routine, concentrating activity into one or two weekends ("weekend warrior" pattern) also significantly reduces cardiovascular risk.
Regarding muscle-strengthening exercise, evidence shows a "J-shaped" association with risk, peaking at 40–60 minutes per week, though more objective data are still needed to verify whether excessive muscle-strengthening activity poses potential risks.
Notably, this review emphasizes the significant advantage of combined (aerobic and muscle-strengthening) physical activity in improving cardiovascular outcomes, generating synergistic protection through hemodynamic improvement, metabolic regulation, and body composition optimization.
The review specifically notes that the cardiovascular benefits of physical activity are more pronounced in populations with pre-existing risk factors. However, while pursuing greater benefits, these individuals must pay more attention to safety limits to avoid exercise-related adverse events. The team says further studies are needed, leveraging objectively measured physical activity data to further deepen the understanding of mechanisms by which it improves health and identifying key biomarkers. Furthermore, with the integration of electronic health records and wearable technology, artificial intelligence and big data analytics are driving the development of intelligent personalized physical activity management systems.
