What is the clinical evidence from this study?

Study design: Review. Population: Atherosclerotic cardiovascular disease (ASCVD). Intervention: Exercise and physical activity vs. Sedentary lifestyle or inactivity.

What does this research mean for the field?

Exercise mitigates atherosclerosis and lowers overall cardiovascular risk by improving lipid profiles, insulin sensitivity, endothelial function, and plaque stability, with ~1000 MET-min/week serving as a pragmatic target. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the complex biological and clinical relationships between exercise, atherogenesis, and cardiovascular outcomes across varying training intensities.

September 25, 2026Journal of Cardiovascular Development and DiseaseOpen Access

Exercise, Atherosclerosis, and Cardiovascular Outcomes: Evidence and Challenges

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Key result

Regular exercise lowers cardiovascular risk, supporting a pragmatic target of ~1000 MET-minutes/week.

Why the study?

The relationship between exercise and atherosclerosis is complex and not fully understood despite exercise being central to cardiovascular primary prevention.

Does exercise improve cardiovascular outcomes and influence atherosclerosis in the general population?

Population

Individuals undergoing cardiovascular primary prevention

Comparison

Exercise including moderate-intensity, resistance training, and high-intensity interval training vs sedentary lifestyle

Design

Review

Authors

MDMohammadmoein DeheshJohns Hopkins University RHReihanehsadat HosseiniWalden University RARias AliUniversity of South Florida

Discussion

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Implication

May guide population exercise targets; leaves open athlete-specific dosing amid plaque paradox.

Key Points

To evaluate the complex biological and clinical relationships between exercise, atherogenesis, and cardiovascular outcomes across varying training intensities.
Synthesized molecular and clinical literature regarding exercise-mediated effects on lipid metabolism, vascular biology, and systemic inflammation.
Evaluated cardiorespiratory outcomes associated with aerobic volume targets, high-intensity interval training, resistance training, and endurance sports.
Physical activity significantly improves lipid parameters (reducing LDL-C, triglycerides, and apolipoprotein B while raising HDL-C and apolipoprotein A-I), enhances insulin sensitivity, and lowers blood pressure.
Exercise exerts direct vascular benefits by improving endothelial function, decreasing oxidative stress and systemic inflammation, and stabilizing coronary plaque phenotypes.
Achieving approximately 1000 MET-minute/week (around 3 hours/week of moderate exercise) optimizes cardiovascular protection, and while elite endurance athletes may show higher plaque burden, their overall mortality risk remains markedly lower than sedentary peers.

Structured PICO

Does exercise improve cardiovascular outcomes and influence atherosclerosis in the general population?

Population

Individuals undergoing cardiovascular primary prevention

Exposure

Exercise (including moderate-intensity, resistance training, and high-intensity interval training)

Comparator

Sedentary lifestyle

Outcome

Atherosclerosis progression and cardiovascular outcomes

This review highlights that while exercise provides broad cardiometabolic and vascular benefits, the optimal prescription varies, and the paradox of increased coronary plaque in endurance athletes does not negate their lower overall cardiovascular risk.

Limitations

The optimal volume, type, and intensity of exercise for different individuals remain inconsistent.
Highly trained endurance athletes may exhibit greater coronary artery plaque burden, though their overall cardiovascular risk remains lower than sedentary individuals.

Cite This Study

Dehesh et al. (2026) conducted a review in Atherosclerotic cardiovascular disease (ASCVD). Exercise and physical activity vs. Sedentary lifestyle or inactivity was evaluated. Regular exercise improves cardiometabolic parameters and reduces cardiovascular risk, with current evidence supporting approximately 1000 MET-minutes/week as a pragmatic population-level target.

synapsesocial.com/papers/6ab61021406bf401c14694cf https://doi.org/10.3390/jcdd13100479

Topics

Coronary artery disease

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Exercise, Atherosclerosis, and Cardiovascular Outcomes: Evidence and Challenges

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Topics

Exercise, Atherosclerosis, and Cardiovascular Outcomes: Evidence and Challenges

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Also Consider

Topics

Also Consider