Regular physical activity (PA) is a cornerstone of good health in the ageing population. Cardiorespiratory fitness is an important surrogate marker for survival. In primary cardiovascular disease prevention, PA is considered an effective mono­therapy with beneficial effects on the cardiovascular risk profile (e.g. lipid profile, blood pressure, diabetes mellitus, body composition) and endothelial function. In secondary prevention, PA is an addition to, rather than a replacement for evidence-based medication.