ACC Statement Urges Doctors to Prescribe Exercise for Heart Health

By cocosomers // 2026-10-24

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Exercise should be prescribed alongside medications and other treatments to prevent and manage cardiovascular disease, according to a new scientific statement from the American College of Cardiology published in the Journal of the American College of Cardiology [1][2]. The statement says clinicians should incorporate physical activity counseling into routine cardiovascular care and treat exercise as a foundational therapy rather than an optional lifestyle recommendation [3][4]. The document, issued by the ACC, states that low cardiorespiratory fitness -- the body's ability to deliver oxygen to muscles during sustained activity -- is a predictor of future cardiovascular disease risk comparable to established risk factors including smoking, high blood pressure, high cholesterol, and diabetes [3]. According to the statement, regular physical activity, structured exercise programs, and improved cardiorespiratory fitness can increase exercise capacity, reduce hospitalizations, and improve quality of life [3]. An umbrella review published in the journal Sports Medicine that analyzed six large research reviews covering more than 31,000 people examined whether cardiorespiratory fitness, most commonly measured through VO2 max, can serve as a diagnostic tool for existing heart disease or a predictor of future cardiac events [5]. Jonathan Myers, PhD, a health research scientist with the Palo Alto VA Healthcare system and chair of the statement's writing committee, said the evidence supporting physical activity is extensive but that exercise remains underutilized in clinical practice [3]. The statement also recommends that routine exercise testing is not necessary before starting physical activity for most people who are asymptomatic or clinically stable, though testing may provide useful information when clinicians need to develop an individualized exercise prescription or assess a patient's exercise capacity [3].

Small Increases in Activity May Provide Benefits

Myers said that start-small guidance is central to the statement's public message. Exercise prescriptions should be tailored to individual needs, including a person's cardiovascular condition, functional capacity, symptoms, treatment goals, and preferences, according to the statement [6][7]. An exercise prescription for heart health is described in clinical literature as a written, individualized plan specifying the type, intensity, duration, and frequency of physical activity -- designed to prevent or manage cardiovascular disease with the same rigor applied to a medication prescription [8]. The ACC statement also recommends combining aerobic and resistance exercise: aerobic activities such as walking and cycling can improve cardiorespiratory fitness, while resistance exercises help build and maintain muscular strength [3]. For most adults, the statement said, aerobic exercise should be paired with resistance training [9]. The statement says wearable devices and virtual or home-based rehabilitation programs may help people monitor their activity and remain engaged with exercise plans, though long-term adherence remains an important consideration [3]. Myers also said the statement recommends monitoring progress through a pedometer or smartwatch, but that expensive equipment or a gym membership is not necessary [3].

Reasons Exercise Remains Under-Prescribed

Myers said many physicians and other health care professionals receive relatively little formal training in exercise prescription, according to Medical News Today [3]. He said clinicians learn a great deal about medications and procedures but comparatively little about how to develop an individualized exercise program [3]. Myers also said that because clinical encounters and appointments are often brief and limited, physical activity counseling can be overshadowed by more urgent medical concerns [3]. Practical barriers to exercise prescription include limited reimbursement, access to exercise programs, and uncertainty about how to prescribe exercise safely in patients with cardiovascular disease, Myers said [3]. The ACC statement itself notes that regular physical activity and structured exercise are foundational for cardiovascular prevention and treatment, yet exercise prescription remains inconsistently integrated into routine cardiovascular care [1]. Myers pointed to the broader gap between evidence and practice as a problem that requires changing how physical activity is incorporated into routine clinical care. He also said a dedicated exercise professional, such as an exercise physiologist, could be routinely incorporated into treatment plans [3]. Research literature supports the position that regular exercise can help control or modify many of the risk factors for heart disease [10].

Cardiac Rehabilitation and Special Populations

The ACC statement identifies cardiac rehabilitation as a first-line treatment for many people with cardiovascular disease and calls for broader access to these programs [3]. Cardiac rehabilitation typically combines structured exercise with other elements of cardiovascular care and support, and it can help people manage their condition and work toward improving their physical capacity and quality of life [3]. Phase III cardiac rehabilitation usually lasts three to six months, according to an appendix on prescriptions, procedures, and programs in Take a Load Off Your Heart [11]. Insurance reimbursement is identified in the statement as one barrier to participation in cardiac rehabilitation [3]. The authors recommend providing individualized exercise prescriptions to people with established cardiovascular disease who cannot participate in formal cardiac rehabilitation, and they call for exercise counseling to become more integrated into routine cardiovascular appointments [3]. Myers said people with and without cardiovascular disease benefit from regular aerobic activity, resistance exercise, and reducing sedentary time, but those with established disease may require a more individualized approach that accounts for their symptoms, functional capacity, medications, and potential exercise-related risks [3]. "Having cardiovascular disease should not automatically be considered a reason to avoid exercise," he said. "In fact, for many patients, exercise is an essential component of treatment. The goal is to identify the safest and most effective approach for each individual". Myers also underscored that people with certain conditions, such as active myocarditis, unstable cardiac symptoms, and some cardiomyopathies, may have to limit exercise for a period of time and require specialized assessment [3].

Conclusion: Call for Integration and Research

The statement calls for additional research into strategies that improve long-term adherence, as well as efforts to expand access to cardiac rehabilitation and integrate exercise counseling into standard care, according to the ACC [3]. Myers said the first step for inactive people is to start small, preferably with an activity they enjoy. He suggested beginning with a 10-minute walk each day and gradually increasing duration or pace as fitness improves, and he encouraged people to look for opportunities to move more throughout the day -- taking the stairs when practical, walking while talking on the phone, or interrupting prolonged sitting with a few minutes of movement [3].

References

Exercise Prescriptions for Cardiovascular Health in Adults: 2026 ACC .... https://www.jacc.org/doi/10.1016/j.jacc.2026.09.008
New scientific statement urges doctors to prescribe exercise for heart health. https://www.news-medical.net/news/20261015/New-scientific-statement-urges-doctors-to-prescribe-exercise-for-heart-health.aspx
New guidance urges doctors to prescribe exercise for heart .... https://www.medicalnewstoday.com/articles/exercise-should-be-prescription-for-healthier-heart-experts-say
Even modest exercise can help protect the heart, experts say. https://knowridge.com/2026/10/even-modest-exercise-can-help-protect-the-heart-experts-say/
Researchers Examine Cardiorespiratory Fitness as Heart Disease Predictor - NaturalNews.com, August 18, 2026.
Heart experts say exercise should always be prescribed .... https://www.scimex.org/newsfeed/heart-experts-say-exercise-should-always-be-prescribed-when-dealing-with-cardiovascular-disease
Exercise should be prescribed as a core component of cardiovascular .... https://medicalxpress.com/news/2026-10-core-component-cardiovascular.html
Exercise Prescription for Heart Health: 8 Key Facts. https://medsbase.com/exercise-prescription-heart-health/
ACC Scientific Statement Recommends Prescribing Exercise in .... https://www.thecardiologyadvisor.com/news/acc-statement-exercise-cardiovascular-care/
Exercise and the Heart. https://www.hopkinsmedicine.org/health/wellness-and-prevention/exercise-and-the-heart
Take a load off your heart 109 things you can actually do to prevent halt or reverse heart disease by Piscatella Joseph C-2

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