CARDIOVASCULAR JOURNAL OF AFRICA • Vol 21, No 4, July/August 2010
196
AFRICA
Concurrent resistance and aerobic training as protection
against heart disease
INA SHAW, BRANDON S SHAW, GREGORY A BROWN, JONES F CILLIERS
Summary
This study was designed to compare the effects of aerobic and
concurrent aerobic and resistance training on their ability
to slow the rate of development and progression of coronary
heart disease (CHD) in young adult males at low risk, as
determined by the Framingham risk assessment (FRA) score.
Subjects were assigned to 16 weeks of three-times weekly
aerobic training (AT) (
n
=
13), concurrent aerobic and resist-
ance training (CART) (
n
=
13) or no exercise (NO) (
n
=
12).
Both AT and CART resulted in significant (
p
<
0.05) changes
in total cholesterol (from 173.67
±
29.93 to 161.75
±
26.78
mg.dl
-1
and from 190.00
±
38.20 to 164.31
±
28.73 mg.dl-1,
respectively), smoking status (from 12.25
±
5.08 to 10.33
±
5.37 cigarettes per day and 12.00
±
4.71 to 8.77
±
5.10 ciga-
rettes per day, respectively), high-density lipoprotein choles-
terol (from 47.00
±
11.85 to 57.50
±
5.99 mg.dl
-1
and 34.00
±
8.53 to 46.77
±
14.32 mg.dl
-1
, respectively), systolic blood pres-
sure (from 126.17
±
7.00 to 122.33
±
3.17 mmHg and 131.54
±
9.28 to 121.69
±
7.87 mmHg, respectively) and therefore
FRA score (from 3.58
±
2.19 to 1.33
±
2.27 and 5.77
±
3.09 to
2.46
±
2.90, respectively). Both modes of exercise were found
to be equally effective in reducing CHD risk. These findings
support the inclusion of resistance training into an aerobic
training programme to lower CHD risk, which will afford
subjects the unique benefits of each mode of exercise.
Keywords:
cardiovascular disease, endurance training, exercise,
risk assessment, weight training
Submitted 6/10/09, accepted 10/3/10
Cardiovasc J Afr
2010;
21
: 196–199
Coronary heart disease (CHD) is the leading cause of death in
western and developed countries, contributing to 60% of all
deaths in the United States of America.
1,2
The Centers for Disease
Control and Prevention (CDC) and the American College of
Sports Medicine (ACSM) recommend that to prevent CHD,
every adult should achieve at least 30 minutes of moderate-
intensity physical activity on preferably all days of the week.
3
While many studies have confirmed the benefit of exercise in
reducing the overall risk of CHD,
4
according to the United States’
Department of Health, three out of five (60%) individuals in the
United States do not achieve the required level of exercise, while
a further 25% of the adult population do not exercise at all.
5
The Framingham risk assessment (FRA) score is the most
widely accepted tool in the United States for patient selection
for primary intervention and prediction of coronary events over
the next 10 years.
6
The National Cholesterol Education Program
(NCEP) Adult Treatment Panel (ATP) III guidelines recommend
FRA risk scoring in assessing absolute risk for CHD events.
7
The search for the cause of CHD was started in the 1940s in
the small community of Framingham in the United States.
8
The
Framingham Heart study was designed to generate information
that would assist in the prevention and early detection of CHD. It
is now the source of much of the knowledge on the risk of CHD
and is synonymous with the ‘risk factor hypothesis’.
The use of the FRA tool is especially important as it is
designed to estimate risk in adults who do not yet have CHD.
The FRA tool also determines CHD risk from a group of vari-
ables (i.e. age, smoking status, systolic blood pressure, total
cholesterol and high-density lipoprotein cholesterol), rather than
from a single variable.
9
This FRA score can then be utilised to
identify patients for primary or preventative treatments, includ-
ing exercise.
Over several decades, volumes of information have been
produced on aerobic training, its adaptations and its benefits
in preventing CHD.
10
Although the specific cardioprotective
benefits of aerobic training are well known, resistance training
is becoming increasingly popular among the general public and
individuals who have substantial mobility limitations (especially
the elderly), which preclude aerobic methods of exercise. This
necessitated the determination of the effects of this mode of
training on CHD risk. Research may reveal additional benefits
from the inclusion of resistance training with or instead of more
traditional modes of aerobic exercise. Well-known benefits of
resistance training include increased muscle strength, increased
lean tissue mass, maintenance of or increase in metabolically
active tissue, and increased neuromuscular control and coordina-
tion.
11
While it is commonly accepted that resistance training should
be regarded as a complementary mode of exercise and not a
substitute for aerobic training,
11
unfortunately, it is not well
understood what the effect of a concurrent aerobic and resistance
training programme would be on CHD risk factors. Just as CHD
is not a single condition, no single exercise-training programme
is optimal for risk reduction in all individuals.
12
Furthermore,
while the necessary quantity and intensity of exercise for the
primary prevention of CHD are becoming understood, most
research to date focuses on the effect of a single mode of exercise
on a single CHD risk variable in isolation.
The purpose of this study was to compare the effect of aerobic
exercise alone, with that of aerobic combined with resistance
Department of Marketing and Sport Management, Vaal
University of Technology, Vanderbijlpark, South Africa
INA SHAW, PhD (Biokinetics)
Department of Sport, Rehabilitation and Dental Sciences,
Tshwane University of Technology, Pretoria, South Africa
BRANDON S SHAW, PhD (Biokinetics),
JONES F CILLIERS (PhD Biokinetics)
Human Performance Laboratory, HPERLS Department,
University of Nebraska, Kearney, USA
GREGORY A. BROWN, PhD (Health and Human Performance)
