# Adding Strength Training to Weekly Exercise May Be Linked to Lower Women’s Heart Attack Risk
Women continue to face a substantial cardiovascular burden, and the search for practical prevention strategies remains active.
A new analysis in *JACC* adds a notable detail to that picture: resistance training may offer measurable heart protection in women, particularly when paired with aerobic exercise.
The findings are observational, but the pattern is consistent and clinically relevant.
This study examined whether regular strength training is associated with lower cardiovascular risk in women.
Using data from more than 117,000 participants in the Nurses’ Health Study and Nurses’ Health Study II, researchers reported lower rates of major cardiovascular disease and myocardial infarction among women who did at least two hours of resistance exercise each week.
Cardiovascular disease is described by the World Heart Federation as the leading cause of death among women worldwide.
Prior research has also indicated that women may be more likely than men to die after a heart attack or stroke.
Against that backdrop, lifestyle measures such as diet, smoking avoidance, alcohol moderation, healthy weight maintenance, and regular exercise are commonly viewed as part of risk reduction.
The new study was published in *JACC*, the flagship journal of the American College of Cardiology.
It focused specifically on resistance training, an exercise type that is widely available and often easier to access than many other structured fitness approaches.
The investigators said this form of exercise has not been as well characterized for women’s cardiovascular risk as aerobic activity has been.
That gap mattered to the research team.
As Edward Giovannucci, MD, ScD, explained, the aim was to determine whether strength training confers distinct cardiovascular benefits for women and whether it could inform more sex-specific prevention strategies.
The study was designed to examine associations, not to prove causation.
The investigators analyzed data from more than 117,000 women enrolled in two large prospective cohorts: the Nurses’ Health Study and Nurses’ Health Study II.
These cohorts provided a long-running observational framework that allowed the researchers to examine exercise habits and later cardiovascular outcomes.
Every four years, participants reported how much resistance training they were doing each week.
That repeated self-reporting allowed the researchers to compare varying levels of strength training over time rather than relying on a single baseline snapshot.
The analysis also looked at combinations of exercise patterns.
In particular, the researchers evaluated women who combined resistance training with the weekly amount of aerobic activity commonly recommended in public health guidance.
They also assessed sedentary television watching, which was used as part of the broader lifestyle profile.
Because this was an observational study based on cohort data, the findings indicate associations.
They do not establish that strength training alone caused the lower risk.
Still, the sample was large, the follow-up structure was repeated, and the exercise exposure was tracked in a way that supports a detailed comparison across activity levels.
The clearest signal in the study involved women who completed at least two hours of strength training each week.
Compared with women who did no resistance training, this group had a 20% lower risk of major cardiovascular disease and a 44% lower risk of heart attack.
The study also found a dose-response pattern.
For each additional hour of strength training per week, women’s risk of major cardiovascular disease fell by 5%, while heart attack risk fell by 14%.
That stepwise relationship is important because it suggests that greater amounts of resistance work were associated with progressively lower risk, rather than the benefit appearing only at one threshold.
Combination patterns were also notable.
Women who added at least two hours of strength training to 150 minutes of aerobic exercise each week had a 45% lower chance of heart attack than women who remained sedentary.
The study further reported that women who met recommended amounts for both resistance and aerobic exercise, and who also watched less than two hours of television per day, had the lowest risks for major cardiovascular disease events, heart attack, and stroke when compared with participants who met only some or none of the recommendations.
Giovannucci interpreted this as evidence that resistance and aerobic exercise may complement each other rather than serve as substitutes.
In the study’s framing, adding strength training did not replace the value of aerobic exercise.
Instead, the two appeared to work together for greater heart protection.
Tianyue Zhang, MD, the study’s first author, said the observed reductions were clinically meaningful.
She emphasized that even relatively modest amounts of resistance training were associated with lower risk, and that the additional benefit seen with each extra hour per week supported a clear dose-response relationship.
The most immediate implication from this report is that strength training may deserve a more central place in discussions of women’s heart health.
The source material presents resistance exercise not as a niche activity, but as a practical form of physical activity that many women can do.
The findings also matter because they suggest exercise planning may need to consider both type and volume.
Aerobic activity has long been emphasized in cardiovascular prevention, but this study indicates that resistance training may add another layer of association with lower cardiovascular risk.
The evidence in the article points to combination activity as the most favorable pattern among those studied.
Clarinda Hougen, MD, who was not involved in the research, offered a physiologic explanation for how strength training could contribute to broader cardiometabolic health.
She noted that resistance exercise supports bone formation and helps preserve lean muscle mass.
She also said skeletal muscle is metabolically active and that increasing muscle mass may improve insulin sensitivity, reduce visceral fat, and support overall cardiometabolic health.
Those remarks do not change the observational nature of the study, but they do provide a biologically plausible context for the associations reported.
The source does not claim that these mechanisms were directly measured in the study itself.
Rather, they were presented as clinical reasoning about why resistance training might matter.
The article also leaves some limits in place.
Because the data were self-reported and observational, the findings should be read as associations within a large cohort, not as proof that two hours of strength training per week will produce the same effect in every woman.
The source does not provide details on exercise intensity, specific resistance-training formats, or whether benefits differed by age or baseline health status.
### What did this study say about strength training and women’s heart attack risk?
The study found that women who did at least two hours of strength training each week had a lower heart attack risk than women who did no resistance training.
The reported reduction was 44% in the study population.
### Did the study suggest strength training works better alone or with aerobic exercise?
The source indicates that resistance exercise and aerobic exercise appeared to work together.
Women who combined at least two hours of strength training with 150 minutes of aerobic activity had a lower chance of heart attack than sedentary women, and the lowest risks were seen in women who met both exercise targets and also had less sedentary TV time.
### How was the study carried out?
Researchers analyzed data from more than 117,000 women in the Nurses’ Health Study and Nurses’ Health Study II.
Participants reported their weekly resistance-training habits every four years, allowing investigators to compare different activity levels over time.
### Does this prove strength training prevents heart disease?
No.
The source describes an observational cohort study, which can identify associations but cannot establish direct causation.
The findings are still important because they show a consistent relationship between more resistance training and lower cardiovascular risk in this large group of women.
This study adds weight to the idea that resistance training belongs in the conversation about women’s cardiovascular prevention.
In a very large cohort, more weekly strength training was associated with lower risk of major cardiovascular disease and heart attack, and the combination of resistance and aerobic exercise appeared most favorable.
The findings are limited to observational data, but the pattern is clear enough to warrant attention.