Cardiology · Medical Literature
Strength Training Linked With Lower Cardiovascular Disease Risk in Women
Abstract
Resistance training is associated with a lower risk of cardiovascular disease (CVD) in women, new research suggests.
Clinical relevance
Despite well-established evidence supporting aerobic exercise for cardiovascular prevention, the independent and additive role of resistance training (RT) in reducing major CVD events in women has remained undercharacterized in large prospective data. This study addresses that gap using long-term, repeated-measures data from over 117,000 women across two major U.S. nurse cohorts, a population representing middle-aged to older women who bear a disproportionate CVD burden. The findings are timely given that RT remains underutilized in women and is not yet consistently integrated into formal cardiovascular prevention counseling.
Key findings
1. In a prospective cohort of 117,025 women followed for a mean of 14.5 years (1,630,964 person-years), 5,459 incident major CVD events occurred (defined as nonfatal/fatal MI, stroke, CABG, or PCI). 2. Women performing ≥2 hours/week of RT had a 20% lower risk of major CVD compared with no RT (HR 0.80; 95% CI, 0.69–0.92; p for trend = 0.007). 3. Women performing ≥2 hours/week of RT had a 44% lower risk of MI specifically (HR 0.56; 95% CI, 0.41–0.76); no statistically significant effect on stroke risk was observed. 4. Each additional hour/week of RT was associated with a 5% lower risk of major CVD and a 14% lower risk of MI. 5. Women who additionally met aerobic activity guidelines (≥150 min/week) and engaged in ≥2 hours/week of RT had a 45% lower risk of MI compared to physically inactive women. 6. Women meeting all three behavioral targets — RT ≥1 h/week, aerobic activity ≥15 MET-hours/week, and TV viewing <2 h/day — had a 40% lower risk of major CVD versus those meeting none; associations were somewhat attenuated after adjustment for BMI and cardiometabolic comorbidities (diabetes, hypertension, hyperlipidemia).
Practice implications
Clinicians counseling women on cardiovascular prevention should specifically prescribe resistance training as a distinct, additive component to aerobic exercise — targeting a minimum of 1–2 hours per week — rather than treating physical activity recommendations as interchangeable. The MI-specific risk reduction (44%) and the dose-response relationship (5% major CVD risk reduction per additional RT hour/week) support incorporating structured RT into prevention plans for middle-aged and older women, particularly those already meeting aerobic guidelines who may derive further incremental benefit. Integrated lifestyle counseling that simultaneously addresses RT engagement, aerobic activity targets, and reduction of sedentary screen time (TV viewing <2 h/day) appears to offer the greatest composite cardiovascular risk reduction in this population.