A new study shows that cholesterol-lowering drugs have a more significant effect when combined with exercise. Though both the drugs and exercise lower the chances of premature death for people with high colesterol, their combined use staved off death better than either on its own.

The study, published in the journal The Lancet, looked at more than 10,000 U.S. veterans, both men and women, who had been diagnosed with a high cholesterol condition called dyslipidaemia. The participants were, on average, 60 years old. Over the course of 10 years, death rates were lowest for study participants who were both taking cholesterol-lowering medication (statins) and got regular exercise.

Study participants who were fit and taking statins lowered their risk of death over the 10-year period by 70%. Those who exercise but did not take statins lowered their risk of death by around 50%. The study participants who were least fit and did not take statins saw their risk of death rise by 35%. The study was controlled for the participants’ age, sex, ethnicity, weight, heart disease history, and the use of other drugs.

“The fitness necessary to attain protection that is much the same or greater than that achieved by statin treatment in unfit individuals is moderate and feasible for many middle-aged and older adults through moderate intensity physical activity such as walking, gardening, and gym classes,” said Dr. Peter Kokkinos, lead author of the study and a researcher at the Veterans Affairs Medical Centre. “Treatment with statins is important, but better fitness improves survival significantly and is a valuable additional treatment or an alternative when statins cannot be taken,”