Exercise Dose in Clinical Practice

Circulation. 2016 Jun 7;133(23):2297-313. doi: 10.1161/CIRCULATIONAHA.116.018093.


There is wide variability in the physical activity patterns of the patients in contemporary clinical cardiovascular practice. This review is designed to address the impact of exercise dose on key cardiovascular risk factors and on mortality. We begin by examining the body of literature that supports a dose-response relationship between exercise and cardiovascular disease risk factors, including plasma lipids, hypertension, diabetes mellitus, and obesity. We next explore the relationship between exercise dose and mortality by reviewing the relevant epidemiological literature underlying current physical activity guideline recommendations. We then expand this discussion to critically examine recent data pertaining to the impact of exercise dose at the lowest and highest ends of the spectrum. Finally, we provide a framework for how the key concepts of exercise dose can be integrated into clinical practice.

Keywords: exercise; hypertension; lipids; mortality.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Biomarkers / blood
  • Blood Glucose / metabolism
  • Blood Pressure
  • Body Weight
  • Cardiovascular Diseases / mortality
  • Cardiovascular Diseases / physiopathology
  • Cardiovascular Diseases / prevention & control*
  • Exercise*
  • Health Status
  • Humans
  • Insulin / blood
  • Lipids / blood
  • Physical Fitness
  • Prognosis
  • Risk Assessment
  • Risk Factors
  • Risk Reduction Behavior*
  • Sedentary Behavior
  • Time Factors


  • Biomarkers
  • Blood Glucose
  • Insulin
  • Lipids