RESISTANCE TRAINING APPLIED TO HEART DISEASES: EVIDENCE ON EFFICACY, SAFETY AND CLINICAL PRESCRIPTION

Abstract

Cardiovascular diseases remain among the leading causes of global morbidity and mortality and require rehabilitation strategies capable of improving functional capacity, autonomy and quality of life. In this context, resistance training has been incorporated into cardiac rehabilitation programs, especially in clinically stable adults; however, its prescription still requires caution regarding dose, hemodynamic response, underlying heart disease and monitoring. This study aimed to synthesize recent evidence on the efficacy, safety and prescription parameters of resistance training in adults with heart diseases. This is a rapid systematic review with narrative synthesis, structured according to PRISMA 2020, PRISMA-S and SWiM principles. Public databases were searched, including PubMed/MEDLINE, PubMed Central, Cochrane Library, PEDro, SciELO and BVS/LILACS, in addition to guidelines and institutional documents. The main evidence window included publications from August 14, 2021 to August 14, 2026, with earlier documents included only when still fundamental and current. Systematic reviews, clinical trials, experimental and observational studies, and case reports relevant to efficacy, safety, hemodynamics, implementation or postoperative context were eligible. The intervention and safety synthesis included 26 reports, corresponding to 25 studies, in addition to contextual sources. The findings indicate that resistance training improves muscle strength, functional capacity and quality of life in stable cardiac patients, especially in coronary artery disease, stable heart failure and controlled hypertension. When combined with aerobic exercise, it may provide modest improvements in peak VO2 and six-minute walk distance. The low frequency of serious adverse events in supervised studies suggests safety in selected populations, although evidence remains insufficient to estimate rare events, mortality or rehospitalization. It is concluded that progressive, submaximal and monitored resistance training is a relevant component of cardiac rehabilitation, provided that it is individually prescribed, considering clinical stability, symptoms, blood pressure, cardiac rhythm, surgical wounds, devices and pharmacotherapy.