Is weight training alone sufficient for maintaining cardiovascular health, or is dedicated cardio endurance training also necessary?

Weight Training Alone Is Insufficient for Optimal Cardiovascular Health

While resistance training provides meaningful cardiovascular benefits, it should be viewed as a complement to—not a replacement for—aerobic exercise to achieve optimal cardiovascular health outcomes including reduced mortality, improved cardiovascular risk factors, and enhanced cardiorespiratory fitness. 1

The Critical Distinction: Cardiovascular Adaptations Differ by Exercise Type

The physiological responses to resistance training versus aerobic exercise are fundamentally different, and these differences matter for long-term cardiovascular outcomes:

Aerobic Exercise Creates Superior Cardiovascular Adaptations

• Aerobic exercise produces large improvements in VO2max (maximal oxygen uptake—the gold standard measure of cardiovascular fitness), while resistance training produces only small improvements at best 1
• Aerobic training substantially reduces resting heart rate (2 arrows indicating moderate effect), whereas resistance training produces no change 1
• Aerobic exercise increases maximal cardiac output and stroke volume, adaptations that resistance training does not provide 1
• Aerobic training produces moderate reductions in both systolic and diastolic blood pressure at rest (20 mm Hg notation), while resistance training shows no effect on resting blood pressure 1
• Cardiorespiratory fitness is the most powerful predictor of mortality and morbidity, exceeding traditional risk factors like smoking, cholesterol, hypertension, and diabetes—and this metric is primarily improved through aerobic exercise 2

Resistance Training Has Limited Cardiovascular Impact

• Resistance training imposes primarily a pressure load rather than a volume load on the cardiovascular system, with disproportionate rises in blood pressure but minimal increases in cardiac output or oxygen consumption 1
• During resistance exercise, stroke volume remains largely unchanged except at very high tension levels where it may actually decrease 1
• The submaximal exercise rate-pressure product (a measure of cardiac workload during everyday activities) is substantially reduced by aerobic training (222 notation indicating large effect) but only moderately reduced by resistance training 1

What the Evidence Shows About Cardiovascular Disease Risk Reduction

Aerobic Exercise Has Convincing Evidence for CVD Prevention

• There is convincing evidence that physical activity reduces cardiovascular disease risk, with cohort research showing that 75 minutes per week of moderate-intensity aerobic activity reduces heart attack and heart failure risk, with greater benefits at 150 minutes and even more at 300+ minutes per week 1
• The key finding is: the more aerobic physical activity, the greater the beneficial effects, with the greatest relative benefit occurring when an inactive person becomes active 1
• Aerobic exercise produces moderate reductions in triglycerides and small increases in HDL cholesterol that contribute to cardiovascular protection 1

Resistance Training Provides Complementary But Not Equivalent Benefits

• Both aerobic and resistance training improve insulin sensitivity and glucose metabolism with similar moderate effects 1
• Resistance training produces beneficial effects on body composition but is less effective than aerobic exercise for absolute fat loss because weight loss is directly related to total energy expenditure 1, 3
• Resistance training enhances muscular strength substantially (111 notation indicating large effect) and increases lean body mass, which aerobic exercise does not 1

The Practical Reality: Your Weight Training Was Beneficial But Incomplete

Your decades of weight training likely provided:

• Moderate improvements in insulin sensitivity and glucose metabolism 1
• Preservation of lean muscle mass and bone mineral density 1
• Some reduction in cardiovascular risk factors, particularly if your training involved circuit-style work with minimal rest 1

However, it almost certainly did not provide:

• Optimal improvements in VO2max and cardiorespiratory fitness—the single most powerful predictor of cardiovascular mortality 1, 2
• Reductions in resting heart rate, a key marker of cardiovascular adaptation 1
• Maximal improvements in blood pressure control 1
• The full spectrum of endothelial function improvements that aerobic exercise provides 4

The Evidence-Based Recommendation

For comprehensive cardiovascular health, you should add dedicated aerobic exercise to your resistance training regimen:

• Perform 150 minutes per week of moderate-intensity aerobic activity (such as brisk walking at 3-4.5 mph) or 75 minutes per week of vigorous-intensity activity (such as jogging), preferably spread across most days of the week 1
• Continue resistance training 2-3 days per week with 8-15 repetitions per muscle group, 1-3 sets of 6-10 different exercises 1
• The combination of both modalities produces superior outcomes for cardiovascular health, metabolic function, and overall mortality risk compared to either alone 3, 5

Common Pitfall to Avoid

Do not assume that elevated heart rate during resistance training equals cardiovascular conditioning. While your heart rate increased during weight training, the physiological adaptations differ fundamentally from aerobic exercise. The pressure load from resistance training does not substitute for the volume load and sustained cardiac output demands of aerobic exercise that drive the most protective cardiovascular adaptations 1. The hemodynamic response during resistance exercise—characterized by dramatic blood pressure increases with minimal oxygen consumption increases—is qualitatively different from the sustained moderate increases in cardiac output and oxygen delivery that occur during aerobic exercise 1.

Your weight training provided real benefits for strength, body composition, and metabolic health, but adding aerobic exercise will address the cardiovascular fitness gap and provide the most robust protection against cardiovascular disease and mortality 1, 2.