Alexander Polyak, Alexander Lee, Martha Gulati
Cardiovascular disease (CVD) remains the leading global cause of mortality, with physical activity (PA) and inactivity playing a significant role in its prevalence and outcomes. PA has been shown to substantially reduce cardiovascular and cardiometabolic risk through mechanisms such as favorable cardiac remodeling, improved endothelial function, and enhanced metabolic regulation. This review explores the broad cardiovascular benefits of PA across both general and diabetic populations, highlighting its impact on reducing disease incidence, improving cardiac function, and lowering cardiovascular mortality. Various forms of PA-including aerobic, resistance, and flexibility and balance training-demonstrate differing but complementary roles in promoting cardiovascular health. Despite strong evidence and guideline endorsements, participation rates remain low, with fewer than a quarter of US adults meeting the minimum PA recommendations. Barriers to PA-personal, environmental, and health-related-remain significant and underaddressed. Enhanced patient education, clinician engagement, and tailored intervention strategies are essential to improve adherence and outcomes. Overall, PA is a critical, evidence-based strategy for reducing CVD risk.