ACC Statement Guides Exercise Prescription for Heart and Vascular Disease

The American College of Cardiology (ACC) has issued a scientific statement offering clinicians practical guidance on prescribing exercise for adults across the spectrum of cardiovascular health and disease. It was published online October 15, 2026, in the Journal of the American College of Cardiology.

According to the writing committee, exercise prescription remains inconsistently integrated into routine cardiovascular care. The statement reviews training approaches, cardiac rehabilitation (CR), exercise testing, and wearable devices across conditions including coronary artery disease (CAD), peripheral artery disease (PAD), heart failure (HF), cardiomyopathies, and hypertension.

The consensus recommendations call for individualized prescriptions and at least 150 minutes per week of moderate-intensity or 75 minutes per week of vigorous-intensity aerobic activity, complemented by resistance exercise for most adults. The authors noted that the greatest absolute benefits occur when inactive individuals begin moving and described approximately 7,000 steps daily as a practical target for many adults. The statement identifies CR as first-line treatment for CAD after recent myocardial infarction, percutaneous coronary intervention, or coronary artery bypass grafting, among other indications. It also identifies supervised or structured exercise therapy as first-line treatment for symptomatic PAD with intermittent claudication.

Routine exercise testing is not required before exercise prescription for most asymptomatic or clinically stable individuals, according to the statement, but should be considered in chronic CAD or HF when symptoms, recent clinical deterioration, or planned vigorous activity raise safety concerns. The committee advised against exercise when resting systolic blood pressure exceeds 200 mm Hg or diastolic pressure exceeds 110 mm Hg and noted that arrhythmogenic cardiomyopathy may worsen with exercise. Wearables are described as adjuncts to counseling and CR, although digital interventions have not shown a significant effect in low socioeconomic status groups.

The authors acknowledged that the evidence base for primary prevention is predominantly observational and that the effect of exercise on clinical events in HF with preserved ejection fraction remains uncertain. They identified long-term adherence, clinical outcomes, diverse populations, and scalable delivery models as research priorities.

Source: Myers J, Beckie TM, Chastin S, et al. Exercise prescriptions for cardiovascular health in adults: 2026 ACC scientific statement: a report of the American College of Cardiology. J Am Coll Cardiol. Published online October 15, 2026. doi:10.1016/j.jacc.2026.09.008