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Research Review: Aerobic Exercise isn’t the Only Path for a Healthy Heart, New Study Shows

Connected Strength Training

Research Review: Aerobic Exercise isn’t the Only Path for a Healthy Heart, New Study Shows

LIU, Y., D.-C. LEE, Y. LI, W. ZHU, R. ZHANG, X. SUI, C. J. LAVIE, and S. N. BLAIR. Associations of Resistance Exercise with Cardiovascular Disease Morbidity and Mortality. Med. Sci. Sports Exerc., Vol. 51, No. 3, pp. 499–508, 2019.


The health benefits of physical activity (PA), primarily endurance aerobic exercises, to reduce cardiovascular disease (CVD) risks and premature mortality are well documented. There is limited research, however, directly examining associations of resistance weight training (RWT) with the risk of CVD and mortality. Most RWT research focuses on bone health, physical function, and quality of life, or metabolic health like type 2 diabetes.

This study evaluated associations of RWT and cardiovascular health and mortality independent of aerobic PA participation.


Investigate associations of RWT, independent of aerobic training, with risk of total CVD events (morbidity and mortality combined), CVD morbidity, and all-cause mortality in a large prospective group of adult men and women.


12,591 participants– 21% women– with a mean age of 47 years were clinical examined over a 19-year period. RWT was assessed using a self-reported, validated questionnaire. Each participate received a comprehensive medical examination that included height, body weight, resting blood pressure, blood samples analyzed for glucose and blood lipids and other markers of CVD. Other data collected included smoking status, alcohol consumption, parental history of CVD, physical activity and leisure time history, alcohol consumption patterns, and resistance weight training history during the past three months.


Among the 12,591 participants, 205 total CVD events, 127 CVD morbidity (nonfatal CVD events), and 276 all-cause deaths occurred during an average follow-up of 5.4, 5.3 and 10.5 years, respectively. The twenty-seven percent of the subjects who regularly engaged in some RWT tended to be male, younger, nonsmokers, more aerobically active, and with lower body mass indexes they also had a lower rate of hypertension, diabetes, hypercholesterolemia, and history of parental CVD.

The association of RWT frequency with both CVD morbidity and all-cause mortality showed a U-shaped curve, with the lowest risk achieved at RE frequency of two times per week.

Compared with no RWT, RWT frequency of one time per week and the total amount of 1–59 min•wk-1 were associated with 75% lower risk of total CVD events, respectively, Compared with no RWT, engaging in RWT of one, two, or three times per week and 1–59 min•wk-1 associated with decreased risk of all- cause mortality. For CVD morbidity, there was a reduced risk of adverse events for RWT frequency of one, two times per week and total amount of 1–59 min•wk-1, compared with no RWT, after adjusting for all potential confounders.


Resistance weight training, especially low-to-moderate frequency (1-3X times per week) or even <1 h•wk-1, associated with lower risks of total CVD events, independent of aerobic exercise participation, compared with no RWT. In addition, higher RWT frequency of at least 4X per week and amount of ≥120 min•wk-1 did not show significant cardiovascular benefits. These results are consistent with the findings of a U-shaped associations between RWT and CVD events. For the associations of RWT with CVD morbidity and all-cause mortality, the results of the dose–response analyses were similar although less strong.

Key Findings

  1. This study suggests that low-to-moderate frequency and amount of resistance weight training associates with reduced risk of nonfatal CVD events, total CVD events, and all-cause mortality independent of the amount of aerobic physical activity participation.
  2. Even one time or less than 1 h•wk-1 of resistance exercise, independent of aerobic exercise, associates with reduced risks of CVD and all-cause mortality.
  3. These results have potential public health applications, especially for the prevention of CVD. These suggest that resistance weight training is needed in addition to aerobic exercise to maximize CVD prevention.