Can isometric exercise training improve arterial stiffness and endothelial function in middle-aged and older adults? A systematic review and meta-analysis of randomized controlled trials.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 42114354 · doi:10.1016/j.maturitas.2026.108973
What was done
Authors systematically searched PubMed, Cochrane Library, Embase, and Web of Science through January 1, 2026, for randomized controlled trials evaluating the effects of isometric exercise training in adults aged 45 years or older. Effect sizes for pulse wave velocity, augmentation index, and flow-mediated dilation were pooled using random- or fixed-effects models to calculate weighted mean differences with 95% confidence intervals.
What was found
Across 10 RCTs totaling 375 participants, isometric exercise training significantly reduced central pulse wave velocity (WMD -1.06 m/s, 95% CI -1.58 to -0.54, P < 0.01) and augmentation index (WMD -4.85%, 95% CI -9.43 to -0.26, P = 0.03). It also significantly increased flow-mediated dilation (WMD 2.87%, 95% CI 1.79 to 3.95, P < 0.01). No significant effect was found for peripheral pulse wave velocity (WMD 0.08 m/s, 95% CI -0.07 to 0.23, P = 0.45).
Why it matters
Isometric exercise training provides an accessible intervention to improve central vascular stiffness and endothelial function in middle-aged and older adults, particularly for those unable to perform traditional aerobic or resistance exercise.
Limits
The total sample size across 10 trials is small (375 participants). The abstract does not specify the types of isometric protocols used, training durations, participant clinical characteristics, or long-term cardiovascular outcomes.
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.