The effect of progressive resistance training on aerobic fitness and strength in adults with coronary heart disease: a systematic review and meta-analysis of randomised controlled trials
Abstract
Design We aimed to evaluate the effect of progressive resistance training on cardiorespiratory fitness and muscular strength in coronary heart disease, when compared to control or aerobic training, and when combined with aerobic training. Secondary aims were to evaluate the safety and efficacy of progressive resistance training on other physiological and clinical outcomes. Methods and results Electronic databases were searched from inception until July 2016. Designs included progressive resistance training vs control, progressive resistance training vs aerobic training, and combined training vs aerobic training. From 268,778 titles, 34 studies were included (1940 participants; 71.9% male; age 60 ± 7 years). Progressive resistance training was more effective than control for lower (standardized mean difference 0.57, 95% confidence interval (0.17-0.96)) and upper (1.43 (0.73-2.13)) body strength. Aerobic fitness improved similarly after progressive resistance training (16.9%) or aerobic training (21.0%); (standardized mean difference -0.13, 95% confidence interval (-0.35-0.08)). Combined training was more effective than aerobic training for aerobic fitness (0.21 (0.09-0.34), lower (0.62 (0.32-0.92)) and upper (0.51 (0.27-0.74)) body strength. Twenty studies reported adverse event information, with five reporting 64 cardiovascular complications, 63 during aerobic training. Conclusion Isolated progressive resistance training resulted in an increase in lower and upper body strength, and improved aerobic fitness to a similar degree as aerobic training in coronary heart disease cohorts. Importantly, when progressive resistance training was added to aerobic training, effects on both fitness and strength were enhanced compared to aerobic training alone. Reporting of adverse events was poor, and clinical gaps were identified for women, older adults, high intensity progressive resistance training and long-term outcomes, warranting future trials to confirm safety and effectiveness.
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Nonfatal cardiovascular complications occur much less frequently during resistance training than aerobic training.
“Nonfatal cardiovascular complications also occur much less frequently during RT than aerobic training (5,183).”
In 23 studies of adults with coronary heart disease, all 63 nonfatal cardiovascular complications occurred during aerobic training, and the 20 musculoskeletal complications during resistance training were caused by preexisting conditions.
“In 23 studies (n = 1174) of adults with coronary heart disease, all 63 nonfatal cardiovascular complications occurred during aerobic training, and the 20 musculoskeletal complications that occurred during RT were caused by preexisting conditions (knee arthritis) and were resolved by changing RT intensity or body position (183).”
The combination of aerobic exercises and resistance training is the most effective option compared with aerobic or resistance exercise alone for improving cardiorespiratory fitness, body composition, and muscle strength.
“the combination of aerobic exercises and RT appears as the most effective option--compared with aerobic or RT exercise alone--for improving CRF, body composition, and muscle strength.80,81”
From Exercise benefits in cardiovascular diseases: From mechanisms to clinical implementation (2023) · cites this paper as [81]
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- Authors
- Hollings, M., Mavros, Y., Freeston, J., & Fiatarone Singh, M.
- Affiliations
- The University of Sydney (AU)
- Exercise, Health and Performance Faculty Research Group, The University of Sydney, Australia
- Corresponding author
- Hollings, Matthew
- Venue
- European Journal of Preventive Cardiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2017-06-05
- Volume
- 24
- Issue
- 12
- Pages
- 1242-1259
- ISSN
- 2047-4873 (ISSN-L)
- 2047-4881
- OpenAlex
- W2623403944
- Cited by
- 148
- References
- 95
- Citations by year
- 2026: 9 · 2025: 22 · 2024: 23 · 2023: 14 · 2022: 18 · 2021: 22 · 2020: 11 · 2019: 18 · 2018: 8 · 2017: 3
- FWCI
- 2.33
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Preventive Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- progressive resistance training, coronary artery disease, cardiorespiratory fitness, muscle strength, combined resistance and aerobic training, cardiovascular complications, exercise safety, older adults, women
- MeSH terms
- Cardiorespiratory Fitness, Coronary Disease, Exercise Therapy, Humans, Randomized Controlled Trials as Topic, Treatment Outcome, Exercise Tolerance, Muscle Strength, Resistance Training
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