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Effect of aerobic exercise training on pulse wave velocity in adults with and without long-term conditions: a systematic review and meta-analysis

Authors: Bakali, M. and Ward, T. C. and Daynes, E. and Jones, A. V. and Hawthorne, G. M. and Latimer, L. and Divall, P. and Graham-Brown, M. and McCann, G. P. and Yates, T. and Steiner, M. C. and Evans, R. A.

Year: 2023 Journal: Open Heart Vol/Issue: Vol. 10, No. 2

Study Characteristics

Lifestyle Pillars
Physical Activity
Study Design
Meta-analysis/Sys Review

Abstract

Rationale

There is conflicting evidence whether aerobic exercise training (AET) reduces pulse wave velocity (PWV) in adults with and without long-term conditions (LTCs).

Objective

To explore whether PWV improves with AET in adults with and without LTC, to quantify the magnitude of any effect and understand the influence of the exercise prescription.

Data Sources

CENTRAL, MEDLINE and EMBASE were among the databases searched.

Eligibility Criteria

We included studies with a PWV measurement before and after supervised AET of at least 3 weeks duration. Exclusion criteria included resistance exercise and alternative measures of arterial stiffness.

Design

Controlled trials were included in a random effects meta-analysis to explore the effect of AET on PWV. Uncontrolled studies were included in a secondary meta-analysis and meta-regression exploring the effect of patient and programme factors on change in PWV. The relevant risk of bias tool was used for each study design.

Results

79 studies (n=3729) were included: 35 controlled studies (21 randomised control trials (RCT) (n=1240) and 12 non-RCT (n=463)) and 44 uncontrolled (n=2026). In the controlled meta- analysis, PWV was significantly reduced following AET (mean (SD) 11 (7) weeks) in adults with and without LTC (mean difference -0.63; 95% CI -0.82 to -0.44; p<0.0001). PWV was similarly reduced between adults with and without LTC (p<0.001). Age, but not specific programme factors, was inversely associated with a reduction in PWV -0.010 (-0.020 to -0.010) m/s, p<0.001.

Discussion

Short-term AET similarly reduces PWV in adults with and without LTC. Whether this effect is sustained and the clinical implications require further investigation.