Strength Training and Heart Attack Risk in Women

Women who did at least two hours of resistance training per week had a 44% lower risk of heart attack compared with women who did none, according to a large study published in the Journal of the American College of Cardiology. The analysis tracked 117,025 women for an average of 14.5 years and found that any amount of strength training was associated with a lower risk of cardiovascular events, with benefits growing as weekly volume increased.

What the study measured

The research pooled data from the Nurses’ Health Study and Nurses’ Health Study II. First author Tianyue Zhang, a visiting scientist at the Harvard T.H. Chan School of Public Health, and colleagues compared self-reported resistance training habits against later cardiovascular outcomes. The association between strength training and lower cardiovascular risk persisted after the researchers adjusted for broader lifestyle and health factors.

How much strength training made a difference

Women who logged at least two hours of resistance training per week had a 20% lower risk of any cardiovascular disease compared with non-lifters, and a 44% lower risk of heart attack specifically. Each additional weekly hour of strength training was tied to another 5% reduction in cardiovascular disease risk. The benefit held across different age groups and body mass index categories.

The study did not find a significant effect on stroke risk. Earlier work offers a useful comparison: a separate analysis of nearly 13,000 adults reported that less than one hour of strength training per week reduced heart attack and stroke risk by 40% to 70%.

Why consistency and combining workouts matter

Women who trained both upper and lower body and maintained resistance training over time saw the strongest results, the study reported. Zhang noted that layering strength training on top of regular aerobic exercise such as walking or running was tied to better heart health. The cardiovascular payoff of staying physically active has been documented for decades, including the long-cited observation that London bus conductors, who moved more than seated drivers, had roughly half the rate of coronary heart disease.

What this means for women’s heart health

Cardiovascular disease remains the leading cause of death among women, according to the American Heart Association, and prior research cited in the study has shown that women are more likely than men to die from a first heart attack involving a completely blocked artery. A separate large international study found that 99% of heart attacks, strokes, and heart failure cases were preceded by at least one measurable risk factor, which underscores how lifestyle interventions like exercise can target those underlying risks.

Current guidelines call for at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic activity per week, plus resistance training on two or more days. The new findings suggest that meeting the resistance component, ideally reaching two hours weekly, can add meaningful protection on top of aerobic exercise.

What researchers say still needs to be studied

Zhang and colleagues called for future studies that include more diverse groups of women and test varying amounts and styles of strength training. They also recommended work that examines how different sedentary behaviors, such as desk work versus extended television viewing, interact with both aerobic and resistance exercise. Continued research on lifestyle strategies to reduce cardiovascular risk is essential, the authors concluded.

FAQ

How much strength training do women need to lower heart attack risk?

The study found that at least two hours of weekly resistance training was linked to a 44% lower risk of heart attack compared with no strength training, and that cardiovascular disease risk dropped another 5% for each additional weekly hour.

Does strength training lower stroke risk too?

The study did not find a significant link between resistance training and stroke risk. A separate analysis of nearly 13,000 adults had earlier reported that less than an hour of strength training per week was associated with 40% to 70% lower risk of both heart attack and stroke.

Should women combine strength training with aerobic exercise?

Yes. The researchers found that layering strength training on top of regular aerobic activity, such as walking or running, was tied to better heart health, and current guidelines already recommend at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic activity weekly plus resistance training on two or more days.