{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T21:50:29Z","timestamp":1788904229754,"version":"build-2803163510"},"reference-count":27,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T00:00:00Z","timestamp":1736899200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Hellenic Cardiology Society (2002)"},{"name":"Hellenic Atherosclerosis Society (2007)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objective: The aim of this study was to assess whether aerobic exercise, as opposed to resistance training or a combination of both, is associated with long-term cardiovascular outcomes. Methods: The ATTICA study is a population-based cohort study with a 20-year follow-up (2002\u20132022); it was conducted in the Attica region, Greece, and included 3042 adult participants (45 \u00b1 11 years, 1518 females). Physical activity engagement in aerobic, resistance, or combined exercise, and 20-year tracking, together with information regarding atherosclerotic cardiovascular disease (ASCVD) incidence were available for 1988 participants (45 \u00b1 12 years old, 987 males, 1001 females). Physical activity levels were evaluated using the validated International Physical Activity Questionnaire, in all follow-up examinations (2001\u20132002, 2006, 2012, and 2022). Cox proportional hazard models were applied; the results are presented as hazard ratio (HR) and 95% confidence intervals (CIs). Results: Participants engaged in the combined (aerobic and resistance) physical activity group had 0.41-times [95%CI (0.20, 0.82)] lower ASCVD risk compared to inactive participants; participants in the healthy engaging aerobic physical activity (HEPA) group had 0.54-times [95%CI (0.36, 0.80)] lower ASCVD risk; no significant associations were observed regarding the minimally active aerobic group [HR, 0.81, 95%CI (0.57, 1.17)], or the resistance training only group [HR, 1.17, 95%CI (0.25, 1.52)]. Conclusions: These findings carry a strong public health message, underscoring the importance of incorporating aerobic or combined aerobic\u2013resistance training into physical activity guidelines to enhance cardiovascular health and reduce the long-term risk of CVD.<\/jats:p>","DOI":"10.3390\/jcm14020522","type":"journal-article","created":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T05:59:42Z","timestamp":1736920782000},"page":"522","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Assessment of Long-Term Engagement in Aerobic Versus Resistance Exercise on 20-Year Cardiovascular Disease Incidence (2002\u20132024): The ATTICA Epidemiological Cohort Study"],"prefix":"10.3390","volume":"14","author":[{"given":"Nikos","family":"Dimitriadis","sequence":"first","affiliation":[{"name":"Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 176 76 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9134-1641","authenticated-orcid":false,"given":"Giannis","family":"Arnaoutis","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 176 76 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6340-3996","authenticated-orcid":false,"given":"Christina","family":"Chrysohoou","sequence":"additional","affiliation":[{"name":"First Cardiology Clinic, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, 115 28 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5940-6895","authenticated-orcid":false,"given":"Fotios","family":"Barkas","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Medical School, University of Ioannina, 451 10 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelos","family":"Liberopoulos","sequence":"additional","affiliation":[{"name":"First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 157 72 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petros P.","family":"Sfikakis","sequence":"additional","affiliation":[{"name":"First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 157 72 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Pitsavos","sequence":"additional","affiliation":[{"name":"First Cardiology Clinic, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, 115 28 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Costas","family":"Tsioufis","sequence":"additional","affiliation":[{"name":"First Cardiology Clinic, School of Medicine, National and Kapodistrian University of Athens, Hippokration Hospital, 115 28 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5817-9395","authenticated-orcid":false,"given":"Konstantinos D.","family":"Tambalis","sequence":"additional","affiliation":[{"name":"School of Physical Education and Sports Science, National and Kapodistrian University of Athens, 115 28 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8583-153X","authenticated-orcid":false,"given":"Demosthenes","family":"Panagiotakos","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 176 76 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3227","DOI":"10.1093\/eurheartj\/ehab484","article-title":"ESC National Cardiac Societies; ESC Scientific Document Group. 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