🏋🏾♂️How Lifting Remodels Women’s Hearts & Heart Health
For most of my career writing for mainstream health, fitness, and endurance sports outlets, the conventional wisdom went like this: you lift weights for your skeletal muscles, and you do “cardio” for your heart. That line has been steadily blurring—especially as more research shows that resistance training benefits cardiovascular health—and a new study pushes it even further for women 40+.
A 2‑year randomized controlled trial in women 60+ found that progressive resistance training didn’t just improve skeletal muscle mass, strength, and functional fitness (as you’d expect); it also produced significant, clinically meaningful, improvements in cardiac structure and function. In other words, lifting remodeled the heart in ways we might have traditionally just credited to aerobic “cardio” exercise.
In the study, the researchers had 64 women either follow a supervised total-body lifting program three days a week or keep living their usual lives, avoiding structured exercise. Everyone had detailed heart ultrasounds, labs, DXA, and strength tests at the start and end.
Changes of Heart
At the end of the study, the side-by-side changes were remarkable:
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Left ventricular mass index (how thick the main pumping chamber wall is relative to body size):
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Training group: −5.5%
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Control: +11%
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Septal thickness (wall between the ventricles):
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Training group: −3.8%
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Control: +7.3%
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Posterior wall thickness:
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Training group: −2.8%
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Control: +13.6%
In plain terms: in the women who didn’t lift, the heart walls thickened the way we expect with aging. In the women who did lift, those walls actually got a bit thinner, suggesting healthier, less stiff remodeling.
Similar structural changes occurred with diastolic function (i.e., filling and relaxation)
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E/E’ septal ratio (an estimate of left ventricular filling pressure; lower is better):
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Training: −11%
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Control: +22.1%
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Tissue Doppler velocities (how well the ventricle relaxes):
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Left atrial volume index (a marker of long‑term filling pressure load):
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Training: −7.1%
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Control: +28.1%
Put simply: the lifters’ hearts relaxed better and filled at lower pressure, with smaller atria, while the non‑lifters’ hearts went in the opposite direction—stiffer, more enlarged, and under higher filling pressure.
Ejection fraction (how much blood the heart pumps out each beat) stayed essentially stable in the training group and declined in the control group (about −1.0% vs −4.9%), which the authors interpret as preserved systolic function with lifting versus age‑related deterioration without it.
Heart of the Matter
Why does this remodeling matter? Because aging and menopause generally shift our cardiovascular framework in unfavorable ways. Heart wall thickening, atrial enlargement, and diastolic dysfunction can progress into heart failure with preserved ejection fraction (aka HFpEF). This is the type of heart failure that disproportionately affects women and is notoriously tough to treat once it’s established.
This trial suggests that long‑term strength training can blunt or reverse wall thickening, maintain atrial size, and keep filling pressures in check, and preserve pumping function.
Of course, the regular lifting routine also helped the women build muscle and get stronger. Their skeletal muscle mass went up +6.9% vs dropping 5.3% in controls. More remarkable: their total strength increased +18.1% vs a big drop of −41.5% in the control group. The lifters improved in all their functional tests like gait speed, 6-minute walk, and sit to stand while they either stayed the same or declined in the control group.
All of this also translated into the lifters enjoying improvements in key metabolic markers, while the control group drifted in the opposite direction. Fasting glucose dropped 8.9% in the training group vs +3.0% in the control group. The lifter’s total cholesterol dropped 7.9% vs +13.9% in the control group and LDL specifically went down 10.0% in the lifters vs +18.9% in the controls.
It’s important to note that the researchers didn’t monitor physical activity outside of the lifting intervention, so it’s possible that the lifters also started engaging in other activity, which can happen when you get stronger and feel better–but honestly, if that’s another heart-healthy side effect, all the better! |
