Aging is accompanied by cardiovascular changes that include a decrease in elasticity and an increase in stiffness of the coronary arteries, which increases the afterload on the left ventricle resulting in systolic hypertension. Unfortunately, hypertension is a major public health problem and appears to be increasing.

Since exercise is a cornerstone therapy for the prevention, treatment, and control of hypertension, lifestyle modifications are strongly encouraged.

Physical inactivity and obesity are major public health concerns throughout the industrialized world. Indeed, obesity and physical inactivity independently contribute to all-cause and cause-specific mortality among young and middle-aged adults.

BMI greater than 25 and physical activity less than 3.5 hours each week together accounted for 31% of all premature deaths.

Aging is commonly associated with an increased incidence of insulin resistance and type 2 diabetes mellitus. Unfortunately, the number of diagnosed cases in the U.S. rose from 1.5 million in 1958 to 17.9 million in 2007, and as of 2009, 23.6 million Americans had type 2 diabetes. In the U.S., diabetes is currently the seventh most common cause of death. However, since it is also a major risk factor for cardiovascular, cerebrovascular disease, peripheral vascular diseases, hypertension, and renal disease, its actual cause of death is significantly higher.

By the age of 50 years, most humans become aware that they are losing endurance and muscle strength due to a loss of muscle mass and adaptive ability The most apparent causes are lack of use, depletion of muscle regeneration stem cells, a decline in anabolic hormones, and decreased physical activity. As a result, muscle strength decreases approximately 50% from age 30 to 80 years, and by the seventh and eighth decades of life, maximal voluntary strength is decreased by 20–40% for men and women in both proximal and distal muscles.

The metabolic syndrome is a combination of cardio-metabolic risk determinants, including central obesity, insulin resistance, glucose intolerance, dyslipidemia, hypertension, hyperinsulinemia, and microalbuminuria. Sisson and associates examined the association of leisure time sedentary behavior (LTSB) and usual occupational/domestic activity with metabolic syndrome and cardiovascular disease (CVD) risk factors in men and women.

Physical activity clearly leads to increased physical fitness, exercise capacity, and risk reduction of various pathological diseases and clinical disorders, resulting in lower morbidity rates, all-cause, and cause-specific mortality, and increased life expectancy.

Although the pathogenesis of atherosclerosis is incompletely understood, inflammation is a widely accepted mechanism. Since CHD is the number one cause of death in the U.S. and in most other Western countries, and cerebrovascular disease is number three, the prevention or delay of these diseases would not only improve the quality of life but increase longevity. As of 2005, twenty-two prospective epidemiologic studies demonstrated that increased blood levels of high sensitivity C-reactive protein (hs-CRP), a sensitive marker of inflammation, is a strong predictor of future CHD. Other studies also showed that physical activity decreases the inflammatory process. For example, a group of 197 patients with CHD was randomized to either a comprehensive lifestyle program (regular physical activity, low-fat diet, smoking cessation) or usual care with routine follow-up for six months. Independent of diet and smoking, physical performance was significantly and inversely correlated with levels of C-reactive protein, interleukin-6, and soluble cell adhesion molecule-1 in patients with CHD, “possibly retarding the process of atherosclerosis.”