According to the World Heart Federation, cardiovascular disease is currently considered the leading cause of death in women on a global scale.
Previous research shows that women are more likely to die from a heart attack or stroke when compared to men.
Scientists believe that making healthy lifestyle choices — such as eating a heart-healthy diet, not smoking, limiting alcohol use, maintaining a healthy weight, and regular exercise — can help lower a woman’s heart disease risk.
Now a new study published in JACC, the flagship journal of the American College of Cardiology, reports that adding at least two hours of strength training to your weekly exercise regimen may help lower your risk for major cardiovascular disease events and myocardial infarction, or heart attack.
For this study, researchers analyzed data from more than 117,000 women who had taken part in the Nurses’ Health Study (NHS) and NHS II.
Every 4 years, study participants were asked to report the amount of resistance training they were doing each week.
“We chose to focus on resistance/strength training because it’s a practical, widely accessible form of exercise that many women can do, yet its specific effects on women’s heart disease risk are not as well understood as aerobic exercise,” Edward Giovannucci, MD, ScD, professor of nutrition at Harvard T.H. Chan School Of Public Health, and co-corresponding author of this study, told Medical News Today.
“Studying it can reveal whether adding or emphasizing strength training offers unique cardiovascular benefits for women and helps refine gender‑specific prevention strategies.”
At the study’s conclusion, researchers found that women who completed two or more hours of strength training a week lowered their risk of major cardiovascular disease by 20% and heart attack by 44%, which compared to women who did no resistance training.
Scientists also found that for every extra hour of strength training a week, female participants decreased their major cardiovascular disease risk by 5% and heart attack risk by 14%.
“These findings suggest that even relatively small amounts of resistance training can meaningfully lower women’s risk of serious heart problems,” Tianyue Zhang, MD, an endocrinologist and medical researcher at the Second Affiliated Hospital of the Zhejiang University School of Medicine in China, scientist in the Department of Nutrition at the Harvard T.H. Chan School of Public Health, and first author of this study, explained to MNT.
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“A 20-44% risk reduction is clinically important, and the fact that each additional hour per week brings further benefits shows a clear dose–response relationship. This supports including resistance training, not just aerobic exercise, as a key part of heart disease prevention strategies for women.”
– Tianyue Zhang, MD
Researchers also found that when women added 2 or more hours a week of strength training with 150 minutes of aerobic activity each week had a 45% lower chance of having a heart attack than women who stayed sedentary.
And women who met the weekly recommended amounts of resistance training and aerobic activity, as well as less than two hours of sedentary TV watching, had the lowest risks for major cardiovascular disease events, heart attack, and stroke, when compared to participants who met some or none of the weekly recommendations.
“This shows that resistance training and aerobic exercise work together to give extra heart protection, rather than replacing each other,” Giovannucci said.
“For women who already meet aerobic guidelines, adding at least two hours of resistance training per week can nearly cut their heart attack risk in half, which strongly supports combining both types of exercise in prevention recommendations.”
– Edward Giovannucci, MD, ScD
MNT spoke with Clarinda Hougen, MD, a primary care sports medicine specialist at Cedars-Sinai Orthopaedics in Los Angeles, CA — who was not involved in this study — about how strength training may help lower a woman’s heart disease risk.
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“Strength training directly targets both bone and muscle health by stimulating bone formation and preserving lean muscle mass,” Hougen detailed.
“Importantly, its benefits extend beyond the musculoskeletal system. Skeletal muscle is metabolically active, and increasing muscle mass can improve insulin sensitivity, reduce visceral fat, and support overall cardiometabolic health.”
“These effects are particularly relevant for women, as cardiometabolic dysfunction is a key contributor to cardiovascular disease. By improving these risk factors, strength training plays an important role in reducing overall heart disease risk.”
Cheng-Han Chen, MD, a board certified interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA, agreed.
“Emerging evidence highlights that strength training is also a key component of an effective exercise program as well as reducing the risk of heart disease in women,” Chen — who was likewise not involved in this study — explained.
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“Resistance-based exercises, including free weights, machines, or bodyweight movements, help build and maintain muscle mass.”
“This is particularly important for women, who experience age-related declines in muscle that can negatively impact metabolic health. When combined with aerobic activity, strength training provides a more comprehensive approach to reducing heart disease risk in women.”
While heart disease remains the leading cause of death among women, women have historically been underrepresented in cardiovascular research, Socrates Kakoulides, MD, a cardiologist and chief imaging officer of Baptist Health Heart & Vascular Care, part of Baptist Health South Florida — who was not a researcher in this study — told MNT.
“We also know that cardiovascular disease can present differently in women, and risk factors such as pregnancy-related complications, menopause, autoimmune diseases, and certain cancer therapies can influence cardiovascular risk,” Kakoulides explained.
“Continued research focusing on women’s health helps us better understand which interventions are most effective, practical, and sustainable for different groups of women.”
“Identifying additional lifestyle strategies that can reduce cardiovascular risk empowers both patients and their doctors to create individualized prevention plans and may ultimately improve long-term outcomes.”
“Women have historically been excluded from cardiovascular research trials,” Amy Ahnert, MD, a board-certified cardiologist and director of the Women’s Heart Program at Atlantic Health Morristown Medical Center, added.
“Due to their under-representation, much of the existing data and recommendations about heart disease in women are extrapolated from studies focused on men.”
“Women are not just small men,” Ahnert, who was also not involved in this study, explained to MNT. “Not only is our biology different; but treatments and prevention strategies may be different as well.”
“The importance of understanding exercise and specifically which types of exercise provide cardiovascular protection for women is yet another area that deserves sex-specific attention.”
