The American Heart Association recommends that “accumulating evidence suggests resistance training is a safe and effective approach for improving cardiovascular health in adults with and without cardiovascular disease. Resistance training not only can improve or maintain muscle mass and strength, but also has favorable physiological and clinical effects on cardiovascular disease and risk factors” (Circulation, Jan 16, 2024;149(3):e217–e231). “Because less than one-third of U.S. adults report participating in the recommended two days per week of resistance training activities, this scientific statement provides practical strategies for the promotion and prescription of resistance training.” However, check with your doctor first, as people with conditions such as heart disease or clotting problems could suffer a heart attack when they exercise or lift weights.
Evidence that Resistance Exercise Helps to Prevent Heart Attacks
Adults who perform 30-60 minutes per week of resistance exercise gain a maximum protection of a 17 percent reduced risk of heart disease and 15 percent reduced risk for death from heart disease, compared to people who do not lift weights (Br J Sports Med, 2022; 56:755–763). This report was based on randomized controlled trials of 2-6 months, since there were limited data on studies lasting longer than six months. Most of the trials limited resistance to no more than 40–80 percent of maximum effort, 2-3 days per week. The American Heart Association report is from heart specialists who reviewed the current literature on how resistance exercise helps to:
• lower high blood pressure
• lower high cholesterol and high triglycerides
• reduce high blood sugar levels
• reduce arterial stiffness
• increase strength and muscle size
• reduce body fat
• treat mental conditions such depression
• increase ability to do everyday tasks such as walking, lifting objects and using muscles
Yet only 2.8 percent of North Americans perform the resistance training of two days per week recommended by the 2018 Federal Physical Activity Guidelines (J Phys Act Health, 2021; 18:S37–S44).
Resistance Versus Aerobic Versus Combined Training
The report goes on to state that combining resistance exercise and aerobic training was associated with greater reductions in heart-attack risk factors:
• obesity (PLoS Med, 2021; 18:e1003687)
• diabetes (Med Sci Sports Exerc, 2017; 49:40–46)
• high cholesterol (Mayo Clin Proc, 2018; 93:419–428)
• heart attack deaths (BMJ, 2020; 370:m2031).
A review of 22 studies on how to grow larger and stronger muscles found that the best way for untrained people to grow muscles is to use lighter weights with more repetitions, even though most trained athletes gained more strength by using heavier weights with fewer repetitions (Human Movement, July 23, 2020;21(4):18-29). Lifting lighter weights with more repetitions reduces your chances of injuring yourself. See How to Become Stronger: Weight Training for Middle-Aged and Older People
Older people and those with certain health problems, or potential- health problems, should not lift heavy weights. Lifting heavy weights can cause a marked increase in blood pressure that can harm certain individuals. People who should not lift heavy weights include those with heart disease, pacemakers, defibrillators, history of strokes, clotting problems, some eye diseases and and various other conditions. Your doctor or a physical therapist can advise you if you are very out of shape or have diabetes, arthritis, muscle damage or other limitations that make conventional exercise difficult.
Elastic Resistance Bands
Scientists reviewed studies on elastic resistance bands, and concluded that strength training with elastic bands could bring you the same gain in strength as lifting heavy weights for both the upper and the lower body (SAGE Open Med, Feb 19, 2019;7:2050312119831116). Training in the studies ranged from 2-5 times a week for 4-12 weeks. See Elastic Resistance Bands Can Make You As Strong As Lifting Weights
My Recommendations
The health benefits of resistance exercises are well established, but some people are at high risk for injuries when they perform resistance exercise with heavy weights. Check with your doctor and get advice and supervision from trained exercise personnel. Never work through localized pain. If it hurts in a local spot during any exercise, immediately stop exercising for that day and if you feel no pain, you can try again on the next day.
Dr. Gabe Mirkin is a Villager. Learn more at www.drmirkin.com
