Resistance Exercise Training in Individuals With and Without Cardiovascular Disease: 2023 Update: A Scientific Statement From the American Heart Association

Abstract

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. This scientific statement is an update of the previous (2007) American Heart Association scientific statement regarding resistance training and cardiovascular disease. Since 2007, accumulating evidence suggests resistance training is a safe and effective approach for improving cardiovascular health in adults with and without cardiovascular disease. This scientific statement summarizes the benefits of resistance training alone or in combination with aerobic training for improving traditional and nontraditional cardiovascular disease risk factors. We also address the utility of resistance training for promoting cardiovascular health in varied healthy and clinical populations. Because less than one-third of US adults report participating in the recommended 2 days per week of resistance training activities, this scientific statement provides practical strategies for the promotion and prescription of resistance training.

Keywords: AHA Scientific Statements; cardiovascular diseases; exercise; resistance training; risk factors.

Figure 1.. Prescription and safety considerations for resistance training.

A, Resistance training prescription components. Muscular strength is the ability of a muscle to generate force, and muscular endurance is the ability of a muscle to perform repeated contractions or maintain a contraction for a prolonged period of time. Lower repetitions (reps) with a heavier weight may better optimize muscular strength. Higher repetitions with a lighter weight may better enhance muscular endurance. Using weight loads that permit 8 to 12 repetitions, in general, will facilitate improvements in both muscular strength and endurance, provide cardiovascular health benefits, and be safe for the general population. B, Contraindications to resistance training. Before initiating an RT program, patients should consult with a physician for absolute and relative contraindications. METS indicates metabolic equivalents of task; 1-RM, 1-repetition maximum; and RT, resistance training.

Figure 2.. Major muscle groups and example exercises.

The name of the major muscle group involved in each exercise is in standard font. Accessory muscle groups involved in exercises are shown in italics. It is not necessary to perform all exercises in each resistance training session. Some compound exercises target >1 major muscle group. Eight to 10 exercises can be selected so that each major muscle group is exercised. Exercises can be completed using machines, free weights, elastic bands, or body weight.

Figure 3.. Summary of resistance exercise training.

CVD indicates cardiovascular disease.