On July 24, 2025, the celebrity of American professional wrestling Hulk Hogan, whose real name was Terry Bollea, died at the age of 71. Hogan had chronic lymphocytic leukemia and background of atrial fibrillation, or FA, a condition in which the upper cameras of the heart, or atria, beat irregularly and, often, quickly. His cause of death has been confirmed as an acute myocardial infarction, commonly known as heart attack.
Hogan became a family name in the 1980s and for a long time has been known to maintain the physical form and a very active lifestyle, despite having had 25 surgeries in 10 years, including neck surgery in May.
Hogan’s death has attracted renewed attention to the importance of maintaining the health of the heart through exercise. Many people think that bodybuilders are the “image” of health. However, the truth is that too much muscle can increase the tension in the heart and can actually be harmful. It may seem ironic, then, that people who exercise at extreme levels and seem healthy on the outside can, in fact, be quite unhealthy inside.
As director of Sports Cardiology on the Anschutz Medical Campus of the University of Colorado, I see patients of all ages and at different levels of physical condition who are interested in promoting health by incorporating the exercise in their lifestyle or optimizing their current exercise program.
Exercise is the basis of good health
When people think of vital signs, they usually think about things such as heart rate, blood pressure, temperature, respiratory rate and blood oxygen levels. However, the American Heart Association also includes “aptitude” as an additional vital sign that should be taken into account when determining the general health of a patient and the risk of heart disease, cancer and death.
While the physical condition can be determined in several ways, the best way is verifying what is known as maximum oxygen consumption, or maximum VO2, through a specialized evaluation called cardiopulmonary exercise test. These can be performed in many medical and clinical offices, and provide a large amount of information related to general health, as well as with cardiac, pulmonary and skeletal muscle function.
Exercise is one of the most effective interventions to prolong life and reduce the risk of developing chronic diseases throughout life, in effect, prolonging useful life and improving health, that is, the amount of years that people spend with good health.
In fact, a great study by the Cleveland Clinic found that a low level of physical condition represents a greater risk of death with the time than other traditional risk factors that people commonly think, such as smoking, diabetes, coronary arteries disease and severe renal disease.
When it comes to the health of the brain, the American association of strokes states the importance of routine exercise and avoid sedentary behavior in its 2024 guidelines on primary prevention of strokes. The risk of stroke increases with the amount of sedentary time that is passed throughout the day and also with the amount of time to watch television, particularly four hours or more per day.
Regarding cognitive deterioration, Alzheimer’s Society states that regular exercise reduces the risk of dementia by almost 20%. In addition, Alzheimer’s risk is twice greater among people who exercise less, compared to people who exercise.
There is also strong evidence that regular exercise reduces the risk of certain types of cancer, especially colon, breast and endometrium cancer. This reduction in cancer risk is achieved through several mechanisms.
On the one hand, obesity is a risk factor for up to 13 forms of cancer, and excess body weight is responsible for approximately 7% of all cancer deaths. Regular exercise helps maintain a healthy weight.
Second, exercise helps maintain certain hormones, such as insulin and sex hormones, within a normal range. When these hormonal levels are too high, they can increase the growth of cancer cells. Exercise also helps stimulate the immune system by improving the body’s ability to combat pathogens and cancer cells. This, in turn, helps prevent the growth of cancer cells and also reduces chronic inflammation, which does not control the tissue and increases the risk of cancer.
Finally, exercise improves the quality of life of all people, regardless of their health or age. In 2023, Hulk Hogan joked: “I am 69 years old, but I feel that I have 39.”
You may be interested: Know the 200 MDD dance that Trump projects and is larger than the White House: what we know
The optimal dose of exercise
The main health organizations, such as the American Association of the Heart, the American Cancer Society and the Department of Health and Human Services, share similar recommendations when it comes to the amount of exercise that people must aspire.
All these organizations recommend doing at least 150 minutes per week of moderate intensity exercise, or at least 75 minutes per week of vigorous intensity exercise. Moderate exercises include activities such as walking at a light pace (2.5 to 4 miles per hour), playing double tennis or raking the patio. Vigorous exercise includes activities such as jogging, running or peeing snow.
A good general rule to find out how difficult a specific exercise is to apply the “speech test”: during the exercise of moderate intensity, it can speak, but not sing, during the activity. During the vigorous intensity exercise, you can say only a few words before having to stop and breathe.
There are many solid data that support these recommendations. For example, in a very large analysis of approximately 48,000 people in a row for 30 years, the risk of death for any cause was approximately 20% lower among which followed physical activity guidelines for Americans.
Life can be busy and some people may find it difficult to do at least 150 minutes of exercise throughout the week. However, the “weekend warriors”, people who do all their exercise in one or two days during the weekend, still receive the benefits of the year. Therefore, a busy lifestyle should not prevent people from doing everything possible to meet guidelines.
What about the amount of steps per day? In a new analysis in The Lancet, compared to walking only 2,000 steps per day, people walking 7,000 steps per day had a 47% lower death risk due to any cause, a 25% lower risk of developing heart disease, approximately 50% less risk of death due to heart disease, 38% less risk of developing dementia. A 37% risk of dying of cancer, a 22% lower depression risk and a 28% lower risk risk.
Historically, people have signed up for 10,000 steps per day, but these new data indicate that huge benefits are obtained simply by walking 7,000 daily steps.
It is never too late to start
A question that many patients ask me, and other doctors, is: “Is it ever too late to start exercising?” There are great data that suggest that people can obtain the benefits even if they do not start an exercise program at 50.
Being sedentary while aging will make the heart and blood vessels harden. When that happens, blood pressure can increase and people may be at risk of other things, such as heart attacks, stroke or heart failure.
However, in a study by previously sedentary adults with an average age of 53 years, two years of regular exercise reversed the stiffness of the heart related to the age that otherwise occurs in the absence of routine exercise.
And it is important to remember that you do not have to look like a bodybuilder or a fitness guru to obtain the benefits of exercise.
Almost three quarters of the total benefit for heart, brain and metabolic health that can be obtained from the exercise will simply be achieved following the guidelines.
*William Cornwell is an associate professor of cardiology at the Anschutz Medical Campus of the University of Colorado.
This article was originally published in The Conversation/Reuters
Follow us on Google News to always keep you informed
