Cardiovascular disease remains the leading cause of mortality globally, claiming millions of lives each year. Traditional preventive efforts have primarily highlighted aerobic exercise forms such as brisk walking, jogging, cycling, and swimming for their well-documented cardiovascular benefits. Resistance training, despite its known positive impacts on musculoskeletal health, muscle strength, and metabolic functions, has been comparatively underexplored in the context of CVD risk reduction. This study bridges that gap, underscoring resistance training’s unique and additive role in mitigating the risk of heart attacks and other major cardiovascular complications.

The research team, led by Dr. Tianyue Zhang of the Harvard T.H. Chan School of Public Health, employed a robust prospective cohort design analyzing data from over 117,000 women participating in the Nurses’ Health Study (NHS) and NHS II. These cohorts provided an extensive age range, averaging 66.8 years in NHS and 48.1 years in NHS II at baseline, allowing the exploration of resistance training’s effects across middle-aged and older female populations — groups often at heightened risk for cardiovascular problems yet inadequately studied for strength training benefits.

Resistance training was meticulously assessed through self-reported metrics collected every four years, including separate evaluation of upper and lower body exercises. Sedentary behavior was primarily measured via the amount of time spent watching television, a known independent risk factor for cardiovascular disease. The primary outcomes of interest were major cardiovascular events, encompassing nonfatal and fatal myocardial infarction (MI), stroke, coronary artery bypass grafting, and percutaneous coronary intervention, ensuring a comprehensive overview of severe cardiovascular developments.

Findings indicate a pronounced protective effect associated with resistance training, especially in lowering the incidence of myocardial infarction. Women engaging in at least two hours of resistance exercises weekly exhibited a remarkable 20% reduction in the risk of major cardiovascular events and an even more striking 44% decrease in the occurrence of heart attacks compared with those abstaining from resistance training. Moreover, each additional hour increment in weekly resistance training conferred an incremental 5% reduction in overall CVD risk and a 14% lower chance of myocardial infarction.

Interestingly, these associations persisted even after adjusting for obesity and cardiometabolic risk factors—including hypertension, diabetes, and dyslipidemia—though the magnitude of effect was somewhat tempered. This observation suggests that resistance training benefits extend beyond weight control and conventional metabolic risk modulation, implicating additional physiological mechanisms such as improved vascular function, enhanced insulin sensitivity, and reductions in systemic inflammation.

Furthermore, the synergistic benefits of combining resistance training with aerobic activity were compelling. Among women who met the recommended 150 minutes per week of aerobic exercise, concurrent engagement in two or more hours of resistance training per week resulted in a striking 45% lower risk of myocardial infarction compared to inactive individuals. The integrative analysis accounting for resistance training, aerobic exercise, and sedentary behavior revealed that women adhering to all three lifestyle recommendations experienced the lowest cardiovascular risk profiles, reinforcing the critical importance of a holistic active lifestyle.

This multifaceted approach to physical activity—targeting varied movement types and minimizing prolonged sedentary time—highlights a paradigm shift in cardiovascular medicine. While aerobic exercise remains foundational, the incorporation of resistance training emerges as an indispensable component to augment cardiovascular resilience, functional capacity, and longevity in women. The data provide substantial evidence that public health guidelines should prioritize strength training alongside aerobic conditioning and sedentary behavior reduction.

However, researchers caution that the reliance on self-reported resistance training introduces potential biases, such as inflated or inaccurate recording. Additionally, the study population predominantly consisted of white, middle-class female nurses, which may limit generalizability across diverse racial, ethnic, and socioeconomic groups. Another challenge remains the inability to disentangle the effects of specific types of resistance training modalities from total resistance training volume, warranting further exploration into which exercise forms confer optimal cardiovascular benefits.

Despite these limitations, the strength of the large, well-characterized cohorts and longitudinal design lends significant credibility to the findings. Harlan M. Krumholz, Editor-in-Chief of JACC, endorsed the research’s implications, stating, “We have long encouraged resistance training, and this study provides strong evidence to reinforce that message. Incorporating resistance training into health routines supports both functional independence and cardiovascular longevity.”

In a clinical landscape where cardiovascular disease prevention commands urgent attention, these findings advocate a transformative shift in exercise prescription for women. Importantly, they recognize resistance training not only as an adjunct to aerobic exercise but as a vital, independent pillar of cardiovascular health promotion. This comprehensive strategy, blending strength with endurance and sedentary behavior reduction, promises to enhance heart health outcomes for millions of women globally.

As further research continues to clarify optimal resistance training regimens tailored to different populations, the current evidence encourages healthcare providers and patients alike to embrace strength training as an essential weapon against cardiovascular disease. Empowering women to include lifting weights into their weekly routines may dramatically decrease heart attack incidences, improve quality of life, and extend years of healthy living. This new paradigm invites a broader societal movement to transform cardiovascular health through diverse, integrative physical activity patterns.

For more detailed information on the study titled “Resistance Training, Aerobic Activity, Television Viewing, and Risk of Major Cardiovascular Events in U.S. Women,” interested parties are encouraged to contact Olivia Walther, Media Relations Manager at the American College of Cardiology.

Subject of Research: People

Article Title: Resistance Training, Aerobic Activity, Television Viewing, and Risk of Major Cardiovascular Events in U.S. Women

News Publication Date: 17-Jun-2026

Web References:

• Journal of the American College of Cardiology (JACC)
• American College of Cardiology

Keywords: Physical exercise, Cardiovascular disorders, Myocardial infarction, Cardiology, Cardiovascular disease, Heart disease, Human health, Health care, Health care policy

Cardiovascular disease (CVD) remains the leading cause of mortality among women in the United States, claiming the lives of over 400,000 women annually. This stark reality underscores the urgent imperative to delineate risk factors that disproportionately impact women. Among these risk factors, chronic stress and stress-related psychiatric conditions such as anxiety, depression, and post-traumatic stress disorder (PTSD) have drawn increasing attention for their profound effects on cardiovascular health. Women experience these disorders at higher rates compared to men, yet the mechanisms linking mental health and cardiovascular risk in women remain incompletely understood.

The widespread use of hormonal contraceptives—by approximately 9.1 million women in the U.S.—adds another layer of complexity. These contraceptives function by modulating endogenous hormone levels, suppressing natural estradiol and progesterone production, but their broader systemic effects, particularly in the context of psychological stress, have remained underexplored. Historically, research on hormonal contraception has largely excluded women with significant psychiatric comorbidities, focusing instead on young, generally healthy populations, thus limiting clinical guidance for women managing both hormone use and mental health challenges.

Bridging this critical knowledge gap, Dr. Jordan Thomas and colleagues undertook an expansive analysis utilizing healthcare records from 31,824 women enrolled in the Mass General Brigham Biobank, a rich repository of longitudinal health data. By cross-referencing diagnostic codes for stress-related disorders, major adverse cardiovascular events (MACE), deep-vein thrombosis, and prescriptions for hormonal contraceptives, the team delineated patterns of cardiovascular risk stratified by mental health status and hormone use.

Their findings reveal a striking dichotomy: in women with anxiety or depression, hormonal contraceptive use was correlated with a reduced risk of major adverse cardiovascular events. This counterintuitive protective association contrasts with the prevailing assumption that hormonal manipulation might exacerbate cardiovascular risk. However, this protective effect was absent in women diagnosed with PTSD, suggesting a potentially differential pathophysiological response linked to this severe stress disorder. These preliminary results raise provocative questions about the mechanisms by which psychological stress modulates hormonal effects on cardiovascular function.

The absence of a protective effect in women with PTSD implicates complex neuroendocrine and immunological pathways, given PTSD’s association with heightened sympathetic nervous system activity, chronic inflammation, and endothelial dysfunction—all contributory factors to cardiovascular pathology. Hormonal contraceptives, by altering estrogen and progesterone levels, may interact with these stress-induced physiological disturbances, modulating cardiovascular risk in ways that warrant further clarification.

Implications for clinical practice are profound. The findings suggest that assessment of psychiatric history, particularly PTSD, could become integral to contraceptive counseling and cardiovascular risk stratification in women. If substantiated through future research, this evidence could guide personalized medicine approaches, optimizing contraceptive choice in the context of mental health to mitigate avoidable cardiovascular events.

Looking forward, Dr. Seligowski’s team envisions a clinical study designed to collect prospective physiological data on the impact of specific hormonal contraceptive formulations on cardiovascular risk markers, including blood pressure regulation, vascular endothelial function, and biomarkers of coagulation—a key determinant of thrombotic risk. This longitudinal study aims to dissect how these parameters differ among women with and without stress-related psychiatric disorders, with participants undergoing annual follow-ups to monitor emergent clinical events such as thrombotic episodes.

Such research endeavors have the potential to unravel the biological substrates driving the observed epidemiological trends and to translate these insights into actionable clinical strategies. By integrating psychiatric evaluation with cardiovascular risk assessment and hormonal management, healthcare providers may in the future avert a significant fraction of female cardiovascular morbidity and mortality currently unaddressed by conventional paradigms.

This pioneering investigation represents a pivotal advancement in the domain of sex-specific medicine, emphasizing the imperative to consider psychological stressors as modulators of cardiovascular risk, particularly in the context of pharmaceutical hormone exposure. As the field moves towards precision medicine, understanding the interdependence of mental health and endocrine influences on cardiac outcomes will be critical to enhancing healthspan and quality of life for women.

Authorship of this study included key contributors from Mass General Brigham—Robyn Ellis, Shady Abohashem, Anahita Dua, Emily Lau, Karen Miller, Rachel Rosovsky, Ahmed Tawakol, and Michael Osborne—reflecting a multidisciplinary collaboration harnessing expertise across psychiatry, cardiovascular medicine, and epidemiology. Disclosure statements note industry relationships for some authors, emphasizing transparency in potential conflicts of interest.

Published in the prestigious journal JAMA Network Open, this research stands as a significant call to action for both the scientific community and clinicians alike. Its findings illuminate the intricate connections between psychiatric health, hormonal regulation, and cardiovascular disease, charting a promising course for future inquiry and intervention strategies aimed at reducing the disproportionate burden of cardiovascular disease among women.

Subject of Research: The investigation focused on the intersection of hormonal contraceptive use, stress-related psychiatric disorders, and their combined influence on cardiovascular and thrombotic risk in women.

Article Title: Hormonal contraceptive use, stress disorders, and cardiovascular and thrombotic risk in women

News Publication Date: 2-Jan-2026

Web References:
DOI link: http://dx.doi.org/10.1001/jamanetworkopen.2025.51878

Keywords: Clinical medicine, cardiovascular disease, hormonal contraception, stress disorders, PTSD, anxiety, depression, thrombosis, women’s health, neurocardiology, precision medicine