Strength Training and Cardiovascular Disease (1 of many to come)
The Importance of Strength Training for Preventing Cardiovascular Disease
For those who have worked with us at Summit Physical Therapy and Performance either for physical therapy or for personal training, you know that we often include strength training into our programs. We are starting a series highlighting the research behind why we incorporate strength training into our programming as an essential aspect of health and wellness for anyone who comes through our doors.
Our first piece here will be focusing on the health benefits of strength training for preventing (and managing) heart disease, which is the number 1 killer of Americans.
Muscle Mass and Cardiovascular Disease
The ATTICA Study followed over 3,000 individuals without pre-existing cardiovascular disease that were 45 years or older for over 10 years. Baseline levels of skeletal muscle mass showed an inverse significant relationship with 10 year cardiovascular disease incidence. Those in the highest 33% for muscle mass had an 81% lower risk of developing cardiovascular disease compared to those in the lowest 33%.
In the paper “Effect of Aerobic and Resistance Exercise on Cardiac Adipose Tissues (2019) in The Journal of the American Medical Association…50 adults with abdominal obesity were split into 3 groups.
Group 1 : 3x week hiugh intensity interval endurance training for 45 minutes.
Group 2 : 3x week resistance training for 45 minutes
Group 3 : Control Group (no exercise)
Both groups significantly reduced their epicardial adipose (fat) tissue by 32% (endurance training) and 24% (resistance training). The resistance training group significantly reduced their pericardial adipose tissue by 31%.
In the paper entitled “Associations of Resistance Exercise with Cardiovascular Disease Morbidity and Mortality (2019) in the Journal: Medicine and Science in Sports and Exercise (MSSE)…they followed >12,000 paticipants with a mean age of 47 for all cause deaths and cardiovascular events over a 5.4 and 10.5 year period. Participants were stratified based on weekly frequency of resistance training and duration.
Compared to those who did not consistently resistance train, weekly frequencies of 1, 2, 3, or 4x/week up to 60 minutes were associated with a 40-70% decreased risk of cardiovascular events. These results were independent of any endurance exercise activities.
When looking at the paper “Comparative Effectiveness of Exercise and Drug Interventions on Mortality Outcomes: Metaepidemiological study (2015) in the British Journal of Sports Medicine, the researchers analyzed 16 (4 exercise and 12 drug) meta-analyses + 3 additional recent exercise trials. This included a total of 305 randomized control trials with 339,000 participants.
They studied the outcomes for 4 major chronic diseases (coronary heart disease, stroke rehabilitation, treatment of heart failure, and prevention of diabetes.)
No statistically significant differences were evident between exercise and drug interventions in secondary prevention of coronary heart disease or pre-diabetes, meaning they were equally effective. Physical activity interventions were more effective than drug treatment in the treatment of patients suffering from a stroke. Lastly, diuretics were more effective than exercise in those experiencing heart failure.
Putting It All Together:
The data and research is clear. Strength training significantly improves the cardiovascular system of the body and helps reduce your risk of developing cardiovascular disease. This doesn’t mean you shouldn’t perform endurance/cardiovascular exercise, but that strength training absolutely has a foundational role in preventing cardiovascular disease and is, unfortunately, often times underutilized in geriatric exercise programming. We understand that initiating a new strength training can be intimidating, which is why we specialize in helping older adults begin a comprehensive strength training program, learn the necessary movements, understand how to safely progress/regress and modify their movements to find what works best for their body.
Practical Implementation
For those new to strength training, it’s essential to start with a structured program that focuses on the major muscle groups. Here are some foundational guidelines:
Frequency: Aim for at least two to three sessions per week.
Intensity: Use a weight or resistance that allows you to perform 8-12 repetitions with good form. The last few reps should feel challenging but doable.
Progression: Gradually increase the weight or resistance as your strength improves.
Variety: Incorporate a mix of compound movements (e.g., squats, deadlifts, push-ups) and isolation exercises (e.g., bicep curls, leg extensions).
Overcoming Barriers
Many people, especially older adults, may feel apprehensive about starting a strength training regimen due to fear of injury or a belief that they are too old. However, research consistently shows that people of all ages can safely benefit from strength training. A position statement from the National Strength and Conditioning Association emphasizes that even individuals in their 80s and 90s experienced significant strength gains and improvements in physical function after engaging in a supervised strength training program. The LiftMor trial further followed >50 postmenopausal women with diagnosed osteopenia/osis who strength trained at high-intensities (barbell back squat, jumping pull ups, deadlifts, and over head press for 5 repetition maximums) for over 8 months without any adverse events beyond basic muscle soreness.
Strength training is safe, effective and, indeed, necessary for all individuals - especially older adults.
Conclusion
Incorporating strength training into your routine is one of the most effective ways to enhance your healthspan and prevent cardiovascular disease (or improve it.) By building and maintaining muscle mass, you can improve metabolic health, reduce the risk of chronic diseases, and enhance your overall quality of life. As the adage goes, "It's not the years in your life but the life in your years that counts." Strength training can add life to your years, making each one healthier and more fulfilling.
At Summit Physical Therapy and Performance in Baltimore, Maryland, we encourage our clients to embrace strength training as a cornerstone of their health regimen. Whether you’re a seasoned athlete or just starting, our team is here to guide you every step of the way. Your journey to a stronger, healthier future begins with the first lift. Let’s make it count.
Dan Chapman
Summit Physical Therapy and Performance
3601 Clipper Mill Road, Baltimore Maryland (Hampden neighborhood.)
