How Much Exercise Do You Need to Lower Your Risk of Cardiovascular Disease?

• Researchers say adults may need to quadruple the current weekly exercise recommendations to achieve substantial heart health benefits.
• Those with lower levels of fitness may need as much as 600 minutes of weekly aerobic activity to lower the risks of heart attack and stroke.
• Experts say the current recommendation of 150 minutes of exercise per week is a solid baseline, but higher levels of activity may yield greater benefits.

A new study suggests that adults should aim for up to 4 times the current recommended amount of aerobic exercise per week for optimal heart health.

The researchers say that adults should engage in aerobic exercise for 560–610 minutes per week to achieve a significant reduction in the risk of heart attack and stroke.

They note that less fit adults may need to exercise more to achieve the same cardiovascular benefits. The results of the study were published on May 19 in published in the British Journal of Sports Medicine.

The American Heart Association (AHA) currently recommends that adults get at least 150 minutes per week of moderate-intensity aerobic activity — exercise that gets you breathing harder and raises your heart rate but still allows you to carry on a conversation — such as walking, cycling, and running.

The study authors say the standard exercise advice may need to shift and be replaced with personalized targets geared toward an individual’s fitness level.

“Current [moderate exercise] guidelines provide a universal but modest safety margin, whereas optimal cardiovascular protection may require substantially higher activity volumes,” the researchers wrote.

Experts said the research reaffirms the importance of regular exercise for heart health, but were skeptical about the high weekly targets.

“This study reinforces what a large body of prior research has already shown: higher levels of moderate-to-vigorous physical activity and cardiorespiratory fitness are associated with a lower risk of developing heart disease,” said Keith Diaz, PhD, a professor of behavioral medicine at Columbia University Medical Center in New York City, a certified exercise physiologist, and a volunteer member of the AHA’s Physical Activity Science Committee. Diaz wasn’t involved in the study.

“However, I would urge caution in interpreting the specific recommendation that people may need three to four times the current physical activity guidelines to substantially reduce heart disease risk,” Diaz told Healthline.

To reach their findings, researchers at Macao Polytechnic University in China analyzed data from slightly more than 17,000 participants in the UK Biobank study from 2013 to 2015.

The average age of the participants was 57 years. About 96% were white, and 56% were female.

The subjects wore a device on their wrist for 7 consecutive days to record their typical exercise levels. They also completed a cycle test to measure their estimated maximum oxygen consumption (VO2 max).

The researchers reported that over a follow-up period of almost 8 years, 1,233 cardiovascular events were reported among participants. These included 874 atrial fibrillation, 156 myocardial infarction, 111 heart failure, and 92 stroke events.

The researchers stated that adults who met the 150 minutes per week exercise guideline experienced a 8% to 9% reduction in cardiovascular risk.

They added that 370 minutes of moderate to vigorous exercise per week was needed for those at the lowest fitness level to achieve a 20% reduction in cardiovascular event risk.

Those at the highest fitness level needed 340 minutes per week to achieve the same results.

To reduce cardiovascular risk by more than 30%, participants needed to engage in 560 to 610 minutes of moderate-to-vigorous exercise per week.

The researchers suggest that the current 150 minutes of exercise per week recommendation provides some protection for heart health, but a higher volume of aerobic activity yields greater benefits.

“Collectively, these findings confirm that current guidelines provide a robust universal minimum threshold for cardiovascular protection while offering a quantifiable fitness-stratified prescription matrix as a complementary clinical tool to guide motivated patients from baseline adherence toward greater cardiovascular resilience,” the study authors wrote.

Kevin Shah, MD, a cardiologist and program director of Heart Failure Outreach at MemorialCare Heart & Vascular Institute at Long Beach Medical Center in California, wasn’t involved in the study but agreed with the researchers’ conclusions.

“The standard recommendation — 150 minutes of moderate to vigorous activity each week — is a solid baseline. But it’s just that: a baseline,” Shah told Healthline.

“More movement can help improve blood pressure, support healthy weight, boost insulin sensitivity, and lower overall cardiometabolic risk. In simple terms, 150 minutes gets you in the door — but doing more may help you feel and function even better,” he said.

Michael Fredericson, MD, a professor of orthopedic surgery at Stanford University, said that while he agreed with the study’s results, he would like to see a different focus. Fredericson wasn’t involved in the study.

“I would change the emphasis of the study results, which suggest that optimal cardiovascular protection may require substantially higher activity volumes than 150 minutes of exercise per week,” he told Healthline.

“This message can be discouraging for those who struggle to exercise. I would rather emphasize that small increases in physical activity and cardiovascular fitness, especially among the least active individuals, produce the largest cardiovascular benefits.”

A sedentary lifestyle can be a major contributor to health issues involving the heart’s muscle, valves, blood vessels, and overall function.

Exercise can also help widen blood vessels, allowing more oxygen to circulate throughout the body.

Regular exercise can also produce other health benefits, including:

• regulation of blood sugar
• improving blood flow
• lowering blood pressure
• balancing cholesterol levels
• maintaining weight
• reducing inflammation

• brisk walking
• hiking
• bicycling
• water aerobics
• jogging

Bert Mandelbaum, MD, a sports medicine specialist, orthopedic surgeon, and co-director of the Regenerative Orthobiologic Center at Cedars-Sinai Orthopaedics in Los Angeles, wasn’t involved in the new study, but said the findings reveal the effects of exercise on longevity.

“Evolution is the machine,” Mandelbaum told Healthline. “The survivors are the fittest.”

Increasing your weekly exercise goals is great in theory, but it isn’t always achievable in practice.

The 150 minutes per week equate to about 2.5 hours of exercise over 7 days. The 600 minutes per week goal is 10 hours over 7 days. That’s about 1 hour and 25 minutes per day.

The researchers reported that only about 12% of participants reached that higher level.

Experts said 600 minutes of exercise per week is probably unrealistic for many people.

“I do not think 600 minutes per week is a particularly practical or realistic target for most adults,” said Diaz. “Currently, less than half of U.S. adults meet the existing recommendation of at least 150 minutes of exercise per week.”

“From a public health perspective, I worry that setting extremely high targets could discourage people who are currently inactive,” he added. “The important message remains that meaningful health benefits occur well below 600 minutes per week, and even modest increases in activity can improve heart health.”

Fredericson shared a similar opinion. “To exercise 600 minutes per week, you need to average 85 minutes per day, which is far beyond what is necessary for substantial health benefits and not feasible for most of the population,” he said. “The key principle is that any increase from baseline provides benefit.”

Fredericson shared some practical tips for getting more exercise:

• Substitute vigorous activity for moderate activity to save time.
• Accumulate activity in shorter bouts throughout the day.
• Use wearable devices and smartphone apps for motivation.
• Integrate activity into daily routines.

Shah said that you don’t have to make the leap to a higher level of exercise all at once. “You don’t have to carve out a full hour at the gym to make exercise count,” he said.

“Small bursts of activity throughout the day can add up. A quick morning bike ride, a walk after dinner, taking the stairs, or even short movement breaks between meetings all contribute. The goal is to build movement into your routine in a way that feels doable. Consistency matters more than doing everything perfectly,” Shah continued.

Shah noted there’s no need to let the number of minutes overwhelm you.

“If you’re not even getting 150 minutes a week, don’t let that number discourage you,” Shah said. “The biggest health gains often come from going from no activity to some activity. Even a few minutes of movement a day can start to improve heart health. Focus on taking that first step — then build from there. Over time, those small efforts can lead to meaningful, lasting change,” he continued.

Mandelbaum encouraged people to “stay away from pills and peptides” and focus on exercise. He noted that aerobic activity is free, accessible to most people, and easy to do.

“The most powerful drug is to step your fitness,” he said. “Everybody is the master of their fate. They’re the captain of their destiny.”