Researchers from Barts and University College London tested 138 novice runners attempting the London Marathon.
Over six months of training, their arteries regained some youthful elasticity, which should reduce the risk of heart attacks and strokes.
And their blood pressure fell as much as if they had been prescribed pills.
Those who were the least fit beforehand appeared to benefit the most.
And smaller amounts of aerobic exercise are likely to have a similar effect, according to the British Heart Foundation (BHF), which funded the study, in the Journal of the American College of Cardiology.
How fast did they run?
It took them between four and a half and five and a half hours, on average, to run the 26.2 miles.
Is it dangerous?
Runners with a pre-existing but undiagnosed heart condition have died attempting marathons – but this is very rare.
What is the best way to train?
Start months before a marathon, begin each session with a warm-up and gradually increase the distance run.
Having rest days between runs allows joints and muscles to recover and strengthen.
Ask a doctor about any health concerns.
How much exercise is needed to keep fit and healthy?
Over the course of every week, adults should do a minimum of either:
150 minutes moderate-intensity exercise, such as brisk walking, doubles tennis or cycling
75 minutes vigorous exercise, such as running, football or rugby
People should also do strengthening activities – such as push-ups, sit-ups or lifting and carrying – at least two times a week to give muscles a good workout.
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BHF’s Prof Metin Avkiran said: “The benefits of exercise are undeniable.
“Keeping active reduces your risk of having a heart attack or stroke and cuts your chances of an early death.
“As the old mantra goes, ‘If exercise were a pill, it would be hailed as a wonder drug.'”