A lot of people who start lifting after 50 hope it can cover everything, so the treadmill can finally go. It can't, at least not completely. Strength training is good for your heart in ways most people underrate, but it does a different job than cardio, and the research points to doing both. After 50, that matters more, because aerobic fitness declines faster with each decade while the payoff from keeping it stays large.
Is Strength Training Good for Your Heart at All?
Yes, and more than its reputation suggests. In the Aerobics Center Longitudinal Study, researchers followed 12,591 adults (mean age 47) who had at least two clinical exams (Liu et al., 2019, Medicine & Science in Sports & Exercise, PMID 30376511). Compared with no resistance exercise, lifting one to three times a week, or a total of 1 to 59 minutes a week, was associated with roughly 40% to 70% lower risk of cardiovascular events. That held after accounting for aerobic exercise and held whether or not people met the cardio guidelines.
Two details are worth noticing. Resistance exercise was self-reported, and the study is observational, so it shows an association, not proof of cause. And the benefit did not keep climbing with more: there was no significant risk reduction at four or more sessions or 60 or more minutes a week.
A larger meta-analysis of 16 prospective cohort studies found a similar shape (Momma et al., 2022, British Journal of Sports Medicine, PMID 35228201). Muscle-strengthening activity was linked to 10% to 17% lower risk of all-cause mortality and cardiovascular disease, independent of aerobic activity. The biggest reduction, about 10% to 20%, showed up at roughly 30 to 60 minutes a week.
The American Heart Association's 2023 scientific statement on resistance training reached a similar conclusion: resistance training is safe and effective for improving cardiovascular health in adults with and without heart disease, alone or combined with aerobic training (Paluch et al., 2024, Circulation, PMID 38059362). The same statement notes that fewer than one in three US adults do the recommended two days a week.
So Why Not Drop Cardio?
Because when researchers put the two side by side, they do not do the same things.
One randomized trial assigned 69 sedentary adults (average age 58) with elevated blood pressure and overweight or obesity to eight weeks of aerobic training, resistance training, a combination, or no exercise (Schroeder et al., 2019, PLoS One, PMID 30615666). Every exercise group trained the same total time: three 60-minute sessions a week, with the combined group doing 30 minutes of each.
| Group (8 weeks, time-matched) | What changed significantly |
|---|---|
| Aerobic only | Cardiorespiratory fitness up 7.7 ml/kg/min; weight and fat mass down about 1 kg each |
| Resistance only | Lower body strength up 13 kg; waist down 1.7 cm |
| Combined | Fitness up 4.9 ml/kg/min; upper and lower body strength up; lean mass up 0.8 kg; diastolic blood pressure down 4 mmHg |
Neither aerobic nor resistance training alone significantly lowered blood pressure in this trial. The combined group was the only one that improved across fitness, strength, body composition, and blood pressure. It is a small, short study, but the pattern is clear: lifting alone did not move aerobic fitness, and cardio alone did not build strength.
A pooled analysis of 11 cohorts in England and Scotland, 80,306 adults aged 30 and up, adds a useful wrinkle (Stamatakis et al., 2018, American Journal of Epidemiology, PMID 29099919). Meeting the strength guideline was associated with lower all-cause and cancer mortality. Meeting the aerobic guideline was the one associated with lower cardiovascular mortality, about 22% lower. Meeting both was associated with lower all-cause mortality than either alone.
Why Does Aerobic Fitness Matter More After 50?
Because it falls faster as you age. In the Baltimore Longitudinal Study of Aging, peak oxygen uptake measured repeatedly in 810 healthy adults declined about 3% to 6% per decade in the 20s and 30s and more than 20% per decade in the 70s and beyond (Fleg et al., 2005, Circulation, PMID 16043637).
That number matters because aerobic fitness tracks closely with survival. In a Cleveland Clinic cohort of 122,007 patients who took treadmill tests, the least fit group had about five times the risk-adjusted mortality of the most fit group (Mandsager et al., 2018, JAMA Network Open, PMID 30646252). That was a retrospective study of people referred for testing, not a trial, but the gap was as large as or larger than the gap for smoking. Lifting, as the trial above showed, is not a reliable way to keep that number up.
What About Blood Pressure?
Both help, in somewhat different ways. A meta-analysis of 93 randomized trials with 5,223 participants found that endurance training lowered resting systolic blood pressure by about 3.5 mmHg and dynamic resistance training by about 1.8 mmHg (Cornelissen and Smart, 2013, Journal of the American Heart Association, PMID 23525435). Resistance training lowered diastolic pressure a bit more, about 3.2 mmHg versus 2.5. Endurance training had its biggest effect in people with hypertension, and resistance training had its biggest effect in people with prehypertension. A small number of isometric studies, such as wall sits and handgrip holds, showed the largest drops of all.
We went deeper on this in how strength training lowers blood pressure after 50. If you are on blood pressure medication, keep your clinician in the loop before changing your training, and do not change the medication on your own.
How Should You Split Your Week?
The US Physical Activity Guidelines treat these as two separate targets: 150 to 300 minutes a week of moderate aerobic activity, or 75 to 150 of vigorous, plus muscle-strengthening work on two or more days (Piercy et al., 2018, JAMA, PMID 30418471). Here is a simple way to cover both this week. Check with your doctor first if you have a heart condition, have been inactive for a long time, or get chest pain or unusual shortness of breath with effort.
1. Lift two or three days a week, 30 to 60 minutes total per week at minimum. The cohort data suggest most of the heart-related association sits in that range. More is fine for strength and muscle; it is not where extra heart benefit seems to come from. 2. Get 150 minutes of moderate cardio. Brisk walking, cycling, rowing, or swimming all count. Moderate means you can talk in full sentences but would not want to sing. 3. Stack them if time is short. In the trial above, 30 minutes of each in one session did more for the overall risk picture than 60 minutes of either alone. A 20-minute bike ride after a strength session is a reasonable start. 4. Add one harder cardio effort once the basics feel routine. For example, 6 rounds of 1 minute hard and 2 minutes easy on a bike. Vigorous minutes count roughly double toward the guideline. 5. Do not count your lifting as your cardio. Even fast-paced circuits raise your heart rate without reliably building aerobic fitness the way sustained cardio does. In our experience, people who drop cardio entirely tend to notice it first on stairs and hills.
If you are not sure how much cardio is enough, our post on how much cardio you actually need after 50 breaks down the minutes and steps. For ordering the two in one session, see should you do cardio before or after lifting.
Key Takeaways
- Strength training is good for your heart: in a cohort of 12,591 adults, lifting one to three times a week was associated with about 40% to 70% lower risk of cardiovascular events, independent of aerobic exercise.
- The heart-related benefit of lifting appears to peak around 30 to 60 minutes a week and does not keep rising with more volume.
- In a time-matched randomized trial of adults around 58, resistance training alone did not improve aerobic fitness, while aerobic training raised it by 7.7 ml/kg/min.
- Combining aerobic and resistance training improved fitness, strength, lean mass, and diastolic blood pressure together, which neither did alone in that trial.
- In a pooled analysis of 80,306 adults, meeting the aerobic guideline was the one linked to lower cardiovascular mortality, and meeting both guidelines was linked to the lowest all-cause mortality.
- Aerobic capacity declines faster with age, more than 20% per decade in the 70s, and low aerobic fitness is strongly linked to higher mortality.
- Strength training cannot fully replace cardio after 50; aim for two or more lifting days plus 150 minutes of moderate cardio a week.
If you want a plan that fits both into your actual week, a free 360° body audit at Oakes Fitness is a good place to start.
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