Should I be doing cardio, strength training, or both for cardiovascular health?

Both modalities are independently beneficial for cardiovascular health and synergistic when combined: aerobic training primarily improves VO2max, endothelial function, and resting heart rate; resistance training primarily reduces visceral fat, improves insulin sensitivity, and reduces resting blood pressure, meta-analysis of combined training programs shows approximately 15–20% greater all-cause mortality risk reduction than either modality alone (Stamatakis et al., BJSM, 2018).

For men 40–55, the minimum effective prescription for cardiovascular health is 150 minutes of moderate aerobic exercise per week plus 2 resistance training sessions per week. The order of priority: establish 150 minutes of aerobic training first (the larger VO2max signal), then add resistance training. Men who do only strength training have better body composition and metabolic health than sedentary men, but significantly lower VO2max than aerobically trained men, and VO2max is the dominant longevity signal. Men who do only aerobic training without any resistance work sacrifice muscle mass and insulin sensitivity advantages that matter increasingly after 40.

Honesty Scale: Solid (1) for the combined training superiority for cardiovascular mortality. Solid (1) for the minimum effective prescription.

What to do: Week structure: 3–4 zone 2 aerobic sessions (30–45 minutes each) + 2 resistance training sessions (45–60 minutes each). Total weekly commitment: approximately 4–5 hours. This is the minimum cardiovascular health maintenance prescription for a man over 40 with no contraindications.

For the full picture, read The Stamina Deep Dive

## Category 7: Supplementation (Creatine, Protein, Micronutrients)