Key result
Women performing ≥2 hours/week of resistance training had a 20% lower risk of major cardiovascular disease compared with no resistance training (HR 0.80; 95% CI 0.69-0.92; P for trend=0.007).
Why the study?
Long-term resistance training may influence cardiovascular health, but evidence in women, particularly in the context of aerobic activity and sedentary behavior, remains limited.
Does long-term resistance training reduce the risk of incident major cardiovascular disease in U.S. women?
Cohort (n=117,025)
Does long-term resistance training reduce the risk of incident major cardiovascular disease in U.S. women?
Consistent resistance training, particularly when combined with aerobic activity and reduced sedentary time, is associated with a significantly lower risk of major cardiovascular events in women.
Answers are grounded in this paper and cite their sources.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“The lowest risks were seen in women who did three things together: met aerobic exercise guidelines, did at least 1 hour per week of resistance training, and watched less than 2 hours of TV per day. So the main message is that, in these two large cohorts of women, moving more, getting stronger, and sitting less were jointly associated with substantially lower cardiovascular risk.”
“Despite its established health benefits, RT is often overlooked as a prevention strategy for CVD, and its impact on CVD risk—especially in middle-aged and older women—remains understudied. A key question is, how much does it add beyond aerobic activity alone?”
“These findings suggest that, within an already active population, RT [resistance training] is associated with additional reductions in CVD risk above and beyond overall aerobic activity. Alongside aerobic activity and reductions in sedentary behavior, RT may be an important component of public health strategies for cardiovascular prevention in women.”
Observational data should not yet change practice; extends evidence on resistance training for CVD prevention in women but requires trials.
BACKGROUND: Long-term resistance training may influence cardiovascular health, but evidence in women, particularly in the context of aerobic activity and sedentary behavior, remains limited. OBJECTIVES: This study sought to examine the association between long-term resistance training and risk of major cardiovascular disease (CVD) in women, and to evaluate joint associations with aerobic activity, sedentary television viewing, and key training-related characteristics. METHODS: We conducted a prospective cohort study among 117,025 women from the Nurses' Health Study (N = 45,669; 2002-2020) and Nurses' Health Study II (N = 71,356; 2003-2017), with up to 5 repeated assessments of physical activity. Resistance training was reported every 4 years, and time-varying cumulative averages were calculated to represent long-term exposure. The primary outcome was incident major CVD, defined as nonfatal or fatal myocardial infarction (MI), stroke, coronary artery bypass grafting, or percutaneous coronary intervention. RESULTS: Over a mean of 14.5 years of follow-up (1,630,964 person-years), 5,459 incident major CVD events occurred. Compared with no resistance training, women performing ≥2 h/wk had a 20% lower risk of major CVD (HR: 0.80; 95% CI: 0.69-0.92; P for trend = 0.007), and each additional 1 h/wk was associated with a 5% lower risk (HR per 1 h/wk: 0.95; 95% CI: 0.92-0.99). The inverse association was stronger for MI (HR for ≥2 h/wk vs none: 0.56; 95% CI: 0.41-0.76) but not evident for stroke (HR: 0.99; 95% CI: 0.80-1.23). Women who met recommendations for aerobic activity (≥15 metabolic equivalent of task hours per week), resistance training (≥1 h/wk), and low sedentary television viewing (<2 h/d) had a lower risk of major CVD (HR: 0.60; 95% CI: 0.53-0.69), than those meeting aerobic and low sedentary television viewing recommendations but not resistance training (HR: 0.73; 95% CI: 0.67-0.80). Greater consistency in maintaining resistance training (≥75% of follow-up) and engaging in both upper and lower limb training were associated with stronger inverse associations. CONCLUSIONS: In this large prospective study of U.S. women, consistent resistance training, especially when integrated with recommended levels of aerobic activity and reduced sedentary television viewing, was associated with a substantially lower risk of major CVD, particularly MI.
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Zhang et al. (2026) conducted a cohort in Major cardiovascular disease (n=117,025). Long-term resistance training vs. No resistance training was evaluated on Incident major CVD, defined as nonfatal or fatal myocardial infarction (MI), stroke, coronary artery bypass grafting, or percutaneous coronary intervention (HR 0.80, 95% CI 0.69-0.92, p=0.007). Women performing ≥2 hours/week of resistance training had a 20% lower risk of major cardiovascular disease compared with no resistance training (HR 0.80; 95% CI 0.69-0.92; P for trend=0.007).
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