Does Strength Training Lower Heart Disease Risk in Women?

I’ve been meaning to write a blog about resistance training for a while.  Mostly to share my experience and to encourage you to engage in this type of activity because of the general health benefits.

A couple of years ago, I made the resolution to add resistance training to my routine.  I ended up enrolling in a supervised program not too far from my home (which made it super convenient to go) where I spend 30 minutes twice per week in sessions where I push various muscles to exhaustion.  I have definitely gotten stronger as a result and I’m starting to see some muscle definition where they used to be none.

At the risk of sounding incredibly vain, the thing I’m most excited about is that when I walk or jog, and look down at my legs, I no longer see a bunch of loose skin jiggling away.  Instead, I see muscles that have filled the empty space contracting with every step.  Aging gracefully?  That’s not for me! I’m going down fighting!

But resistance training is not just about building muscle (which has multiple benefits as I will outline below).  Turns out it’s also about reducing your risk of heart disease!

A study published just this week found that women who lift weights at least two hours per week had a 20% lower risk of major cardiovascular disease and a 44% lower risk of heart attack compared to women who did none. Those are not small numbers.  Statins reduce your risk of heart attack by 25-33%.

The study followed 117,025 women from the Nurses' Health Study over many years, tracking their resistance training habits, aerobic activity, and sedentary time. This is large, well-designed research — and the findings add meaningfully to what we already know about exercise and heart health.

What Did the Study Find?

That the risk reduction was independent.  Meaning, it held even after adjusting for BMI and conditions like diabetes, high blood pressure, and high cholesterol.

And the benefits went beyond strength training alone. Women who combined two or more hours of weekly resistance training with 150 minutes of aerobic activity had a 45% lower risk of heart attack compared to women who did no exercise at all. And women who met all three recommendations — resistance training, aerobic activity, and limiting time spent sitting — had the lowest cardiovascular risk of anyone in the study.

That's a consistent pattern. It's not about any single behavior. It's about building an active life.

Why Would Lifting Weights Help Your Heart?

It seems counterintuitive at first. Aerobic exercise has a clear cardiovascular story — direct effects on heart rate, circulation, and blood pressure. Strength training feels like it belongs in a different category.

But muscle mass matters more for heart health than most people realize. Building and maintaining muscle improves insulin sensitivity, lowers blood pressure, reduces triglycerides, and helps with body weight over time, and all of those feed directly into cardiovascular risk. Resistance training also reduces systemic inflammation, which plays a significant role in how heart disease develops.

There's also the sedentary behavior piece. The study used TV viewing time as its measure of sitting, and prolonged sedentary time is now recognized as an independent cardiovascular risk factor. Moving more — in any form — counters that risk.

Does This Apply If You're Already Active?

Yes, and that's one of the more striking findings. Among women who were already meeting aerobic activity guidelines, adding resistance training still provided additional protection. This wasn't a case where benefits only showed up in sedentary women. Even within an active group, lifting added measurable cardiovascular benefit on top of what aerobic exercise alone was doing.

Many active women skip strength training, assuming that walking or cycling is enough. This data suggests that's leaving something real on the table. 

What's the Practical Takeaway?

Current U.S. guidelines recommend at least two days of resistance training per week alongside 150 minutes of moderate aerobic activity. This study supports both parts of that recommendation and adds context for why meeting the full picture — rather than just one piece — produces the best outcomes.

Resistance training doesn't require a gym or heavy weights. Body weight exercises, resistance bands, and light dumbbells all qualify. The key is working muscles against a force consistently over time. 

The Bigger Point

This is another piece of evidence pointing to the same underlying truth: cardiovascular disease is largely a lifestyle disease, and the choices we make every day shape our risk in measurable ways. Exercise is one lever. Nutrition is another, and a powerful one.

The foods you eat consistently, across years and decades, determine a great deal about how your arteries age. Soluble fiber, plant sterols, and omega-3 fatty acids have direct, clinically documented effects on LDL cholesterol, triglycerides, and vascular inflammation — the same biological pathways that resistance training helps address through a different route.

Exercise and nutrition aren't competing strategies. They're additive, and the research keeps confirming it.