The burden of cardiovascular and metabolic disease continues to increase in China, driven by converging risk factors such as obesity, hypertension, abnormalities of glucose and lipid metabolism, insulin resistance, prolonged sedentary behavior, and declining cardiorespiratory fitness. The source argues health management must move beyond episodic disease treatment toward prevention, preservation of function, and long-term health management.
The article defines exercise prescription as a medical intervention derived from a baseline medical assessment, risk stratification, and measurement of exercise capacity. It entails individualized design of exercise frequency, intensity, time, type, total volume and progression, together with dynamic monitoring and iterative adjustment. As a clinical tool, exercise prescription is intended to be precise, measurable and adaptable to the individual patient.
Unlike generic exercise recommendations, an exercise prescription emphasizes quantification (particularly of intensity and total dose), individual precision, objective monitoring, and the ability to adjust the program over time. This level of specification differentiates clinical exercise prescription from broad public-health guidance and supports its use as a targeted medical intervention.
According to the source, existing evidence shows that standardized and regulated exercise prescription can improve multiple cardiometabolic outcomes. Reported benefits include reductions or improvements in blood pressure, blood glucose, blood lipids, body weight and body composition, and enhancements in cardiorespiratory fitness. The article positions exercise prescription as an important tool for controlling risk factors such as obesity, hypertension, and dysregulated glucose and lipid metabolism, and as an integral component across the management continuum for conditions including coronary heart disease, heart failure, and diabetes rehabilitation.
The review summarizes plausible mechanisms by which exercise exerts cardiometabolic protection. These include improvements in endothelial function, regulation of inflammatory and immune pathways, optimization of mitochondrial function, and enhancement of multi-organ metabolic processes. The combined effect of these mechanisms is presented as the physiologic basis for the observed changes in risk factors and functional capacity.
Exercise prescription is described as applicable both for prevention and for disease-specific management. In prevention it targets control of obesity, hypertension, and dysglycemia/dyslipidemia. Clinically, it can be integrated into the care pathways and rehabilitation programs for coronary heart disease, chronic heart failure, and diabetes. The framework envisions exercise prescription as spanning risk-factor modification, disease management, and post-acute rehabilitation.
The source emphasizes the need for medical assessment and risk stratification prior to initiating exercise prescription, recognizing safety boundaries must be established. However, the abstract does not report specific stratification algorithms, monitoring thresholds, or detailed safety protocols; those details would be expected in the full text.
Multiple real-world obstacles to implementing exercise prescription in clinical practice are identified. These include insufficient pre-exercise risk screening, lack of standardized execution and adherence to prescribed programs, shortages of trained personnel able to deliver and monitor prescriptions, incomplete multidisciplinary collaboration, and limited long-term follow-up evidence to support sustained outcomes and program durability. These gaps constrain widespread, safe, and effective translation.
The authors call for efforts to promote standardized, precision-based and intelligent approaches to exercise prescription. Although the abstract does not provide detailed roadmaps, it highlights the need for improved risk stratification protocols, better training and workforce development, stronger multidisciplinary coordination, objective monitoring tools, and generation of long-term follow-up evidence to support durable clinical implementation.
The review frames exercise prescription as an important, evidence-supported medical intervention for cardiometabolic health that differs from general exercise advice by its emphasis on individualized intensity, total dose, monitorability and dynamic adjustment. While benefits across blood pressure, glycemic and lipid control, weight and fitness are supported by existing evidence, clinical translation faces challenges in safety screening, consistent implementation, professional capacity and long-term evidence. The article reviews these topics and proposes directions to advance standardized, precise and intelligent exercise prescription in clinical practice.
(Article source: Z H Jia, F Wang. Zhonghua Xin Xue Guan Bing Za Zhi. 2026. PMID: 42736128. DOI: 10.3760/cma.j.cn112148-20260515-00318.)