The Effects Of Aerobic Endurance Exercise On PWV And IMT In Adults:A Systematic Review And Meta-Analysis

Objectives The aim of this study was to perform a systematic review and meta-analysis of randomized controlled trails (RCTs) or cohort studies that evaluated the effect of aerobic endurance exercise on pulse wave velocity(PWV) and intima media thickness(IMT) in adults. IMT and PWV were the most commonly used parameters for the assessment of arterial stiffness.Methods The MEDLINE, Cochrane, ISI and Ovid databases were searched between January 2000 and February 2015. The titles and abstracts of the retrieved articles were assessed by two reviewers independently. Abstracts that did not provide sufficient information about the inclusion and exclusion criteria were further evaluated by assessing the full text. Data extraction was also independently conducted by the two researchers. Data analysis was performed with Review Manager Software (RevMan 5.1; Cochrane Collaboration, Oxford, UK).Results A total of 1654 participants in 26 RCTs and 2 cohort studies were included in the meta-analysis. In studies for which PWV was the outcome, aerobic endurance exercise had a significant effect on reducing PWV [-0.67, 95%CI-0.97,-0.38; I2=89%; heterogeneity, p<0.0001].And changes in peripheral arterial PWV were statistically greater than in central arterial PWV. In the RCTs for which IMT was the outcome, changes [-0.04,95%CI-0.12,0.04; P=95%; heterogeneity, p＜0.00001] in IMT did not reach statistical significance. In the two cohort studies, changes [-8.81,95%CI-9.25,-8.37; I2=22%; heterogeneity, p=0.26] in IMT were statistically significant. Subgroup analysis indicated a longer duration aerobic exercise and a greater improvement of VO2max were associated with larger reductions in PWV. Reductions in IMT were observed in two cohort studies, but not in 4 RCTs.Conclusions The meta-analysis suggests that aerobic endurance exercise contributed to reducing arterial stiffness in adults, particularly peripheral PWV. A longer duration of aerobic endurance exercise and a greater relative improvement of VO2max contributed to more significant reductions in PWV.