People with Strong Chest and Back Muscles Less Likely to Have a Heart Attack

• People with healthier chest and back muscles were far less likely to experience a heart attack — Participants with denser skeletal muscle had a substantially lower risk of future cardiovascular events.

For every 10-unit increase in muscle density on the scan, the risk of a heart attack fell by 31%, while the risk of death during the following decade fell by 39%. In contrast, people whose muscle quality ranked below the median faced an 85% higher risk of dying and a 58% higher risk of having a heart attack than those with healthier muscles.

• Muscle quality mattered much more than muscle size — The researchers found that simply having larger muscles didn't predict better heart health. Instead, the key factor was how healthy the muscle tissue was on the inside. Muscles with less fat mixed between the muscle fibers appeared denser on CT scans and were associated with better long-term outcomes.

Think of it like comparing a lean cut of steak with one heavily marbled with fat; both may weigh the same, but their internal composition is very different.

• Strong chest and back muscles remained important even after accounting for conventional heart risk factors — Researchers adjusted the results for age, sex, and coronary artery calcium, which measures hardened plaque inside the arteries. Even after those adjustments, skeletal muscle quality continued to predict future heart attacks, while several other body measurements lost their significance.

That means your chest and back muscles provided important information about your heart health that conventional risk markers alone didn't fully capture.

• Everyday exercise that strengthens your upper body could improve the muscles linked to heart health — The researchers explained that the protective finding wasn't limited to weightlifting. Activities that strengthen your chest, back, and core muscles, such as resistance training, cycling, Pilates, and brisk walking, all have the potential to improve muscle quality.²

The goal isn't to build the biggest muscles possible but to develop healthier, leaner muscle tissue with less fat inside it, which was the characteristic linked to a lower risk of heart attack.

• The findings suggest that your muscles reflect more than your strength — The researchers suggested that heart scans could eventually identify people whose poorer muscle quality places them at greater cardiovascular risk before a heart attack occurs.

While additional research is needed to determine exactly how improvements in muscle quality affect heart attack risk, this study suggests one point: Healthier chest and back muscles are closely linked to better long-term heart health and deserve the same attention as many conventional cardiovascular risk factors.

1. Strengthen your back with rowing movements — Upper back muscles were among the muscles linked to better long-term heart health in the study. A simple bent-over row is an excellent place to begin.³ Stand with your feet about hip-width apart and soften your knees slightly. Push your hips backward while keeping your back flat, allowing a pair of light dumbbells to hang below your shoulders.

Pull the weights toward your lower ribs while gently squeezing your shoulder blades together, then lower them slowly. If you're just getting started, perform one or two sets of eight to 12 repetitions with a weight you control comfortably.

2. Train your chest with presses and wall pushups — Chest muscles also appeared in the heart scans analyzed by the researchers, making them another worthwhile target. If you have dumbbells, lie on your back with your feet flat on the floor, lower the weights until your elbows lightly touch the floor, then press them upward until your arms almost meet above your chest.

If dumbbells aren't available, start with wall pushups. Place your hands on a wall at chest height, keep your body in a straight line from head to heels, lower your chest toward the wall, and press back.⁴ As you become stronger, progress to pushups against a sturdy bench or countertop before working toward floor pushups.

3. Target your back and shoulders from different angles — Single-arm rowing exercises improve your back while also challenging your balance and core. Step one foot behind you into a comfortable lunge, rest your front hand on your front thigh for support, and hold a dumbbell in your other hand. Pull the weight toward your lower ribs, pause briefly, and lower it under control before repeating. Finish one side before switching to the other.

Another valuable exercise is the reverse fly. Hinge forward at your hips with a light dumbbell in each hand, maintain a slight bend in your elbows, and raise your arms out to your sides until they reach shoulder height before lowering them slowly.⁵ Both exercises strengthen the muscles that stabilize your shoulders and upper back.

4. Make consistency your goal instead of intensity — You don't need marathon workouts to improve muscle quality. I recommend two strength sessions each week, along with regular walking, cycling, or other activities you enjoy. Track your progress by adding one repetition, using a slightly heavier weight, or improving your technique every couple of weeks. Those small victories keep you motivated and build stronger muscle over time.

5. Fuel your muscles so they recover and grow stronger — Exercise is only part of the equation. Your muscles also need adequate nutrition to repair themselves after each workout. Distribute high-quality protein across your meals throughout the day rather than concentrating it in one sitting. Aim for about 0.8 grams per pound (or 1.76 grams per kilogram) of lean body mass, with one-third coming from collagen-rich sources like slow-cooked meats or bone broth.

Pair your meals with healthy carbohydrate sources such as whole fruit, root vegetables, and white rice to replenish muscle energy and support recovery. Stronger muscles develop through the combination of regular training, adequate recovery, and consistent nutrition, not from exercise alone.