This study analyzed the effects of the pyramidal resistance training (RT) system with two repetition zones on cardiovascular risk factors in older women (≥60 years old). Fifty-nine older women were randomly assigned in three groups: non-exercise control (CON, n = 19), narrow-pyramid system (NPR, n = 20), and wide-pyramid system (WPR, n = 20). Training was performed for eight weeks (eight exercises for the whole-body, 3x/week) in which NPR and WPR performed three sets of 12/10/8 and 15/10/5 repetitions, respectively. Regional body fat was estimated by dual-energy X-ray absorptiometry, and blood parameters related to glycemic, lipid, and inflammatory profiles were assessed. After the training period, although no difference was observed for the magnitude of the changes between NPR and WPR, significant group by time interactions indicated benefits with RT compared to CON for reducing body fat (mainly android body fat; −7%) and improving glucose, HDL-C, LDL-C and C-reactive protein (p < 0.05). Composite z-score of cardiovascular risk, created by the average of the intervention effects on the outcomes, indicate similar responses between NPR and WPR, differing from CON (p < 0.001). Results indicate that both the repetition zones of the pyramidal RT reduced similarly the cardiovascular risk in older women.