Effects of aerobic, resistance and combined training on endothelial function and arterial stiffness in older adults: A systematic review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 39621701 · doi:10.1371/journal.pone.0308600
What was done
The authors conducted a systematic review and meta-analysis of randomized clinical trials from PubMed, Cochrane, LILACS, EMBASE, Web of Science, and gray literature. They evaluated the effects of aerobic, resistance, and combined training on flow-mediated dilation (FMD) and pulse wave velocity (PWV) in older adults across 24 RCTs (intervention group n = 251, mean age 67.7 ± 5.6 years; control group n = 228, mean age 68.7 ± 5.9 years). Methodological quality was evaluated using Cochrane RoB2 and GRADE, and mean differences were pooled using random-effects inverse variance models.
What was found
Aerobic training significantly improved FMD (mean difference 0.64% [95% CI 0.24 to 1.03], p = 0.002) and improved PWV (-1.21 m/s [95% CI -1.37 to -1.05], p < 0.001) compared to control. Subgroup analyses showed no FMD differences following aerobic training in healthy adults compared to those with any health condition. Combined training also improved FMD (0.60% [95% CI 0.50 to 0.71], p < 0.001) and PWV (-0.79 m/s [95% CI -1.23 to -0.35], p = 0.002). Resistance training did not show improvement in either parameter.
Why it matters
This review indicates that aerobic and combined exercise training, but not resistance training alone, improve vascular endothelial function and arterial stiffness in older adults.
Limits
The total sample size across 24 trials was relatively small at 479 participants. The analysis evaluating resistance training on PWV included only a single study, preventing meaningful conclusions for that modality. GRADE quality of evidence was very low for combined training and moderate for aerobic and resistance training.
Cited by
- supports Damage to the endothelium from cholesterol, hypertension, and smoking causes atherosclerotic disease, and endothelial function is improved by exercise training at any point in life.