Adults with stable coronary artery disease have better cardiac health – including lower odds of dying from cardiovascular events – when they are vigorously active one to two days a week, according to Italian researchers.

The investigators looked at 32,000 participants with stable heart disease who ranged from sedentary to highly active. The group that performed vigorous physical activity once or twice per week had the lowest risk for cardiovascular death, myocardial infarction, and stroke. Additional weekly activity did not appear to further increase health benefits. Meanwhile, sedentary patients had the highest risk for experiencing these adverse cardiac events.

The findings may reassure patients with stable coronary artery disease that exercise is safe, and in fact less risky than remaining sedentary, said Simone Biscaglia, M.D., of the Azienda Ospedaliero-Universitaria di Ferrara, Italy.

“The goal should be to exercise every week, not to achieve the highest possible frequency, since this is unlikely to be sustainable and does not translate into better outcomes,” said Biscaglia this fall in a statement to the European Society of Cardiology.

“Fear of having a heart attack should not be a barrier to physical activity,” she concluded.

The study was published in the European Journal of Preventive Cardiology.