Keeping fit and active in old age or taking cholesterol-busting statins are both vital for preventing early death.
And when the two are combined, it dramatically slashes the chances of dying early by up to 70 per cent, scientists found after a 10-year study of 10,000 people.
Experts are already calling for everyone over the age of 50 to be prescribed statins to ward off chronic and potentially fatal conditions, even if the patients are at low risk.
They say administering statins to an extra five million people would cut heart attacks and strokes by 10,000 a year and save at least 2,000 lives.
The pills, which cost as little as 40p a day and are taken by eight million Britons to reduce cholesterol and protect against heart attacks, heart disease and stroke, have also been shown to be a potent cancer-buster.
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
US scientists studied 10,000 men and women with an average age of 60 and diagnosed with the high cholesterol condition dyslipidaemia.
All had their fitness graded and were divided into those taking statins and those not.
Over 10 years, death rates were lowest for people who were both fit and taking statins.
That group had a 70 per cent reduced risk of death.
For those who were fit but not taking the pills, the chances of dying were reduced by just under 50 per cent.
According to the study, published in The Lancet, the differences could not be explained by factors such as age, weight, ethnicity, sex, heart disease history and other drugs.
Leader of the study, Dr Peter Kokkinos, of the Veterans Affairs Medical Center in Washington, said unfit middle-aged and older people would only need to undertake “moderate and feasible” activity such as walking, gardening, and gym classes to gain the same or greater protection than that achieved by statins.
He urged people with high cholesterol to improve their fitness to at least a moderate level.
He added: “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.”
Natasha Stewart, senior cardiac nurse at the British Heart Foundation, said: “This research shows that the two together (statins and exercise) can provide a winning combination to further improve your heart health, with higher intensity exercise possibly offering more protection.
“If you have high cholesterol, speak to your doctor about the best treatment regime.”
The most common dyslipidaemias are high blood cholesterol and triglyceride levels (hyperlipidaemia), high levels of low-density lipoprotein (LDL or “bad”) cholesterol and low levels of high-density lipoprotein (HDL or “good”) cholesterol.
Statins slightly raise the chance of some “at risk” patients developing diabetes, but their benefits in reducing the likelihood of cardiovascular disease far outweigh risks.
The National Institute for Health and Clinical Excellence currently recommends that statins are given to those with a 20 per cent or greater chance of developing cardiovascular disease within 10 years.