Original research
The association between resistance exercise and cardiovascular disease risk in women

https://doi.org/10.1016/j.jsams.2014.09.009Get rights and content

Abstract

Objectives

The objective of this study was to examine the association between resistance exercise and cardiovascular disease risk, independent of body composition, physical activity and aerobic capacity, in healthy women.

Design

A cross-sectional analysis including 7321 women with no history of heart disease, hypertension or diabetes was performed.

Methods

Participation in resistance exercise was self-reported and body weight and height was measured. A single cardiovascular disease risk score was established via factor analysis including percent body fat, mean arterial pressure, fasting glucose, total cholesterol and triglyceride levels. Physical activity level was determined based on questionnaire data and aerobic capacity was assessed via a maximal treadmill exercise test.

Results

Women reporting resistance exercise had lower total cardiovascular disease risk at any age. Specifically, resistance exercise was associated with lower body fat, fasting glucose and total cholesterol. The association between resistance exercise and cardiovascular disease risk, however, remained only in normal weight women after adjusting for physical activity and aerobic capacity.

Conclusion

Results of the present study underline the importance of resistance exercise as part of a healthy and active lifestyle in women across all ages. Our results suggest that resistance exercise may be particularly beneficial to independently improve cardiovascular disease risk profiles in women with normal weight. In overweight/obese women, total physical activity and aerobic capacity may have a stronger association with cardiovascular disease risk.

Introduction

Cardiovascular disease (CVD) is the leading cause of death in the United States with higher CVD mortality in women compared to men.1, 2 Regular physical activity (PA) has been shown to reduce CVD risk.3 Due to the reduction of PA during activities of daily living over the past several decades,4 exercise becomes an increasingly important component in achieving a sufficient amount of PA.

The benefits of aerobic exercise, consisting of continuous activation of large muscle groups, on CVD risk have been well documented.5 Resistance exercise (RE) consists of repeated bouts of isolated muscle groups and, therefore, exerts different physiologic effects and health benefits than aerobic exercise. Previous research has shown positive effects of RE regarding musculoskeletal function and weight management.6, 7 An increase in muscle mass in response to RE, however, potentially affects various CVD risk factors as skeletal muscle is a major tissue regarding glucose and triglyceride metabolism.8 For example, RE has been associated with a 23% risk reduction for coronary heart disease in men and improved endothelial function in men and women.9, 10 Furthermore, muscular strength, which is directly related to muscle mass, has been associated with a reduction in the incidence of metabolic syndrome in men,11 as well as numerous other benefits on CVD risk factors and CVD prognosis.12 Clinical and randomized controlled trials showed beneficial effects of RE on blood pressure but results on the effects of RE on blood lipid and glucose levels have been equivocal.5, 8, 13

Previous research, however, focused predominantly on at risk populations such as overweight or obese, individuals with metabolic syndrome and impaired glucose metabolism, or elderly. Further, most research considered specific risk factors separately rather than examining the association of RE and a composite CVD risk score. As currently less than 20% of U.S. women engage in regular RE,14 more information on potential benefits of RE, beyond the well-established positive effects on the muscular-skeletal system, is needed. The purpose of the present study was to examine the association between overall CVD risk, as well as specific CVD risk factors, and RE independent of aerobic capacity or cardiorespiratory fitness (CRF) and PA in healthy women.

Section snippets

Methods

This cross-sectional analysis was done in a population of 7321 women from the Aerobics Center Longitudinal Study (ACLS) who had an examination between 1987 and 2007. The procedures used in the ACLS have been well-described previously.15 Participants included in the study were between 20 and 90 years of age and with no history of heart disease, hypertension or diabetes. Participants provided written informed consent prior to data collection and the study was approved by the Cooper Institute

Results

Thirty-seven percent of the participating women reported current engagement in some type of RE, including calisthenics, free weights and weight machines, as well as other forms of RE. Descriptive characteristics of the study population are shown in Table 1. In the total sample, 29.1% of the women were classified as overweight or obese, with a higher prevalence of overweight/obesity in women not reporting RE (34.5% vs. 20.0%); PA and CRF were higher in women reporting engagement in RE, even

Discussion

Results of the present study suggest that RE is associated with CVD risk, independent of leisure-time PA and CRF. Specifically, RE was associated with a lower BF, as well as lower levels of cholesterol, triglycerides and blood glucose. As expected, CVD risk was higher in older women, however, there were differences in BF and total cholesterol between those that performed RE and those that did not, across all age groups. Women aged 56 years and older also displayed lower triglyceride levels with

Conclusion

Most likely, a combination of aerobic and RE will provide the largest health benefits. The inverse association between engagement in RE and overall CVD risk, independent of total PA and CRF indicates that benefits of regular RE go beyond the well-established effects on muscular strength, bone mineral density and functional capacity. Such information may help with the promotion of regular RE, which has been identified as a national health perspective.30 More research, however, is needed to

Practical implications

  • Engagement in resistance exercise reduces cardiovascular disease (CVD) risk in women independent of leisure physical activity level and aerobic fitness.

  • Engagement in resistance exercise reduces cardiovascular disease risk at all ages.

  • The effect of resistance exercise on CVD risk is more pronounced in normal weight compared to overweight women.

  • The benefits of resistance exercise warrant an inclusion of resistance exercise in health-related exercise programs.

Acknowledgements

This study was supported by National Institutes of Health Grants AG06945, HL62508, and DK088195. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

The authors also thank the Cooper Clinic physicians and technicians for collecting the baseline data and staff at the Cooper Institute for data entry and data management.

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