Comparison of the Cardiovascular Benefits of Resistance, Aerobic, and Combined Exercise - CardioRACE

Contribution To Literature:

The CardioRACE trial showed that aerobic exercise alone or combined with resistance training improves a composite cardiovascular risk profile.


The goal of the trial was to evaluate different exercise strategies compared with control among patients with overweight/obesity.

Study Design

  • Randomized
  • Parallel

Patients with overweight or obesity were randomized to supervised resistance training (n = 102) vs. aerobic training (n = 101), vs. combined resistance/aerobic training (n = 101), vs. control (n = 102).

Exercise time was 50 minutes in the resistance group, 50 minutes in the aerobic group, and 25 minutes of resistance training with 25 minutes of aerobic training in the combination group, three times per week.

  • Total number of enrollees: 406
  • Duration of follow-up: 12 months
  • Mean patient age: 50 years
  • Percentage female: 53%
  • Percentage with diabetes: 2%

Inclusion criteria:

  • Overweight or obesity
  • 35-70 years of age
  • Elevated blood pressure
  • Nonsmokers
  • Inactive for the last 3 months

Exclusion criteria:

  • Cardiovascular disease
  • Cancer
  • Severe arthritis

Principal Findings:

The primary outcome, change in composite cardiovascular disease risk Z-score (systolic blood pressure, low-density lipoprotein cholesterol, fasting glucose, and percent body fat) at 1 year vs. control, was -0.02 in the resistance group (p = 0.69), vs. -0.15 in the aerobic group (p = 0.01), vs. -0.16 in the control group (p = 0.009).


Among overweight and obese patients, aerobic training alone or combined with resistance training improves a composite cardiovascular disease risk profile. Supervised exercise programs with resistance/aerobic exercise or aerobic exercise alone should be recommended to overweight and obese individuals. Large clinical effectiveness studies are needed.


Lee DC, Brellenthin AG, Lanningham-Foster LM, Kohut ML, Li Y. Aerobic, resistance, or combined exercise training and cardiovascular risk profile in overweight or obese adults: the CardioRACE trial. Eur Heart J 2024;Jan 17:[Epub ahead of print].

Clinical Topics: Diabetes and Cardiometabolic Disease, Prevention, Exercise

Keywords: Cardiometabolic Risk Factors, Exercise, Obesity

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