What type of physical exercise should be recommended for improving arterial stiffness on adult population? A network meta-analysis

Author: Alicia Saz-Lara1, Iván Cavero-Redondo1,2, Celia Álvarez-Bueno1,3, Blanca Notario-Pacheco1, Sara Reina-Gutiérrez1, Irene Sequí-Domínguez1, Jonatan R Ruiz4, Vicente Martínez-Vizcaíno1,5
1 Universidad de Castilla-La Mancha, Health and Social Research Center, Santa Teresa Jornet s/n, 16171 Cuenca, Spain.
2 Rehabilitation in Health Research Center (CIRES), Universidad de las Americas, Av. República 71, Santiago, Chile.
3 Universidad Politécnica y Artística del Paraguay, Mayor Sebastián Bullo, 001518 Asunción, Paraguay.
4 PROmoting FITness and Health through physical activity Research Group (PROFITH), Department of Physical Activity and Sports Education, Sport and Health, University Research Institute (iMUDS), Faculty of Sports Science, University of Granada, Crta Alfacar s/n. 18011 Granada, Spain.
5 Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Av. Pedro de Valdivia 425, Talca, Chile.
Conference/Journal: Eur J Cardiovasc Nurs
Date published: 2021 Apr 9
Other: Special Notes: doi: 10.1093/eurjcn/zvab022. , Word Count: 268

Physical exercise has been associated with a reduction in arterial stiffness, a subclinical process underlying cardiovascular disease. However, the effect of different types of exercise (aerobic, resistance, combined, interval training, stretching, or mind-body modalities) on arterial stiffness is unclear. This network meta-analysis aimed to examine the effectiveness of different types of exercise on arterial stiffness as measured by pulse wave velocity in adults.

Methods and results:
We searched Cochrane Central Register of Controlled Trials, CINAHL, MEDLINE (via Pubmed), Embase, and Web of Science databases, for randomized clinical trials including at least a comparison group, from their inception to 30 June 2020. A frequentist network meta-analysis was performed to compare the effect of different types of physical exercise on arterial stiffness as measured by pulse wave velocity. Finally, 35 studies, with a total of 1125 participants for exercise intervention and 633 participants for the control group, were included. In the pairwise meta-analyses, the exercises that improved arterial stiffness were: interval training [effect size (ES) 0.37; 95% confidence interval (CI) 0.01-0.73], aerobic exercise (ES 0.30; 95% CI 0.13-0.48) and combined exercise (ES 0.22; 95% CI 0.04-0.40). Furthermore, the network meta-analysis showed that mind-body interventions were the most effective type of exercise to reduce the pulse wave velocity (ES 0.86; 95% CI 0.04-1.69). In addition, combined exercise (ES 0.35; 95% CI 0.08-0.62), aerobic exercise (ES 0.33; 95% CI 0.09-0.57), and interval training (ES 0.33; 95% CI 0.02-0.64) showed significant improvements.

Our findings showed that aerobic exercise, combined exercise, interval training, and mind-body exercises were the most effective exercise modalities for reducing arterial stiffness, assuming an important role in the prevention of cardiovascular diseases.

Keywords: Adults; Arterial stiffness; Cardiovascular disease; Physical exercise; Pulse wave velocity.

PMID: 33837399 DOI: 10.1093/eurjcn/zvab022