What does this research mean for the field?

Combined aerobic and resistance training significantly improves peak oxygen consumption, muscle strength, and health-related quality of life while reducing mortality compared to non-exercising usual care in patients with coronary heart disease. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

August 4, 2026Sports Medicine - OpenOpen Access

Effect of Combined Aerobic and Resistance Training on Exercise Capacity, Muscle Strength, Quality of Life, and Mortality in Patients with Coronary Heart Disease: A Systematic Review with Meta-analysis

Q: What is the clinical evidence from this study?

Study design: Systematic Review. Population: Coronary Heart Disease (CHD) (n=5388). Intervention: Combined aerobic and resistance training (CART) vs. Non-exercising usual care, aerobic training, or resistance training. Primary outcome: Relative peak oxygen consumption (peak VO2) compared to non-exercising usual care (MD 2.20, 95% CI 1.57-2.83, p=<0.0001).

Q: What question did this study set out to answer?

To analyze the effects of combined aerobic and resistance training on exercise capacity, muscle strength, quality of life, and mortality in patients with coronary heart disease.

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Key result

Combined aerobic and resistance training cuts mortality ~60% vs. usual care in coronary heart disease.

MD 2.20
95% CI 1.57-2.83
P<0.0001
n=5,388

Why the study?

Little data existed regarding the effects of combined aerobic and resistance training on exercise capacity, muscle strength, health-related quality of life, and mortality in coronary heart disease patients.

Does combined aerobic and resistance training improve exercise capacity, muscle strength, quality of life, and mortality in patients with coronary heart disease?

Population

Patients with coronary heart disease in published randomized controlled trials

Comparison

Combined aerobic and resistance training vs non-exercising usual care, aerobic training, or resistance training

Design

Systematic review and meta-analysis of randomized controlled trials

Authors

CGCaroline Oliveira GoisUniversidade Federal de Sergipe AGAlana Lalucha de Andrade GuimarãesUniversidade Federal de Sergipe LCLino Sérgio Rocha ConceiçãoCross-Cutting Cardiology

Discussion

Member takes

Implication

Supports incorporating combined training into cardiac rehabilitation for coronary heart disease; extends RCT evidence with mortality benefit.

Key Points

To analyze the effects of combined aerobic and resistance training on exercise capacity, muscle strength, quality of life, and mortality in patients with coronary heart disease.
Systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating combined aerobic and resistance training for coronary heart disease
Search conducted in multiple medical databases including MEDLINE/PubMed and Cochrane Central Register of Controlled Trials
Calculations of mean difference (MD), standardized mean difference (SMD), risk ratio (RR), and 95% confidence intervals (CIs) for outcomes.
CART improved peak VO2 by 2.20 ml/kg/min (P < 0.0001) and reduced mortality (RR = 0.40; P = 0.002) compared to usual care.
Significant improvements in muscle strength with peak torque increasing by 16.69 N.m (P < 0.0001) and handgrip strength by 4.68 kgf (P < 0.0001).
CART was superior to aerobic training in enhancing peak VO2 and 6MWD, while also improving quality of life significantly (P < 0.00001).

Study Design

Type

Systematic Review (n=5,388)

Structured PICO

Does combined aerobic and resistance training improve exercise capacity, muscle strength, quality of life, and mortality in patients with coronary heart disease?

Population

5,388 patients with coronary heart disease from 61 randomized controlled trials evaluating the effects of combined aerobic and resistance training.

Intervention

Combined aerobic and resistance training (CART), average of 3 days per week for an average of 16 weeks.

Comparator

Control group (aerobic training, resistance exercise) or no intervention (non-exercising usual care).

Outcome

Exercise capacity (peak VO2 and 6-min walking distance), muscle strength (1-repetition maximum, peak torque and handgrip strength), health-related quality of life (HRQoL), and mortality.

Main Result

Mean Difference: 2.2 (95% CI 1.57–2.83)

p-value: p=<0.0001

Combined aerobic and resistance training significantly improves exercise capacity, muscle strength, quality of life, and reduces mortality in patients with coronary heart disease compared to usual care or aerobic training alone.

Limitations

None of the included studies blinded the therapists and participants
41 included studies did not report concealed allocation
45 studies did not report blind assessors
21 studies did not report intention-to-treat analysis

Cite This Study

Gois et al. (2026) conducted a systematic review in Coronary Heart Disease (CHD) (n=5,388). Combined aerobic and resistance training (CART) vs. Non-exercising usual care, aerobic training, or resistance training was evaluated on Relative peak oxygen consumption (peak VO2) compared to non-exercising usual care (MD 2.20, 95% CI 1.57-2.83, p=<0.0001). Combined aerobic and resistance training significantly improved relative peak VO2 by 2.20 ml/kg/min and reduced mortality (RR 0.40) compared to non-exercising usual care in patients with coronary heart disease.

synapsesocial.com/papers/6a71b6ecc47350ef8e494e42 https://doi.org/10.1186/s40798-026-01080-3

Topics

Cardiac Rehabilitation and Lifestyle Interventions

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Implication

Supports incorporating combined training into cardiac rehabilitation for coronary heart disease; extends RCT evidence with mortality benefit.

Effect of Combined Aerobic and Resistance Training on Exercise Capacity, Muscle Strength, Quality of Life, and Mortality in Patients with Coronary Heart Disease: A Systematic Review with Meta-analysis

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Topics

Effect of Combined Aerobic and Resistance Training on Exercise Capacity, Muscle Strength, Quality of Life, and Mortality in Patients with Coronary Heart Disease: A Systematic Review with Meta-analysis

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Topics

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