Exercise is widely recognized as essential for good health, but the risks associated with physical inactivity are often underestimated. Decades of research have shown that regularly moving the body can significantly reduce the risk of cardiovascular disease and support healthier aging.

One of the earliest landmark studies came in the 1950s, when epidemiologist Jeremy Morris examined more than 30,000 employees of London’s transportation system. He found that bus drivers, who spent most of their shifts sitting, faced a higher risk of coronary heart disease than conductors, who regularly walked through buses and climbed stairs while collecting fares. The study helped establish physical activity as an important factor in preventing heart disease, laying the groundwork for decades of research.

The Recommended Activity Level

Evidence now links regular physical activity with lower risks of heart disease, stroke and diabetes, as well as longer life expectancy. The American Heart Association includes physical activity among its eight key measures for cardiovascular health.

Federal guidelines recommend at least 150 minutes of moderate-intensity physical activity each week, along with muscle-strengthening activities on at least two days. Importantly, achieving these benefits does not require reaching a specific target such as 10,000 steps every day.

Yet millions of people remain insufficiently active. According to the American Heart Association’s 2026 Heart Disease and Stroke Statistics report, fewer than half of U.S. adults meet recommended levels of aerobic activity. Only about one in five achieve recommended targets for both aerobic and muscle-strengthening exercise.

The Modern “Bus Driver” Problem

Technology and changing work patterns have made prolonged sitting increasingly common. Desks, computers and screens have transformed the workplace, creating a modern version of the sedentary lifestyle Morris observed decades ago.

Physical inactivity has consequently become a major global public-health concern and contributes to millions of deaths worldwide each year.

Exercise as Part of Medical Care

Despite its importance, physical inactivity is rarely treated as a cardiovascular risk factor in the same systematic way as high blood pressure or high cholesterol.

One notable exception is cardiac rehabilitation. Patients recovering from heart attacks, coronary stent procedures, bypass operations or heart valve surgery may be prescribed supervised exercise programs. Research shows that cardiac rehabilitation can reduce hospitalizations and the risk of death.

However, participation remains low, with fewer than one-third of eligible patients taking part.

The broader message is straightforward: improving heart health does not require extreme exercise or a perfect step count. Consistent movement, combined with strength training, can make a meaningful difference.

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