The effect of aerobic exercises on arterial stiffness in older people: A systematic review and meta-analysis.

BACKGROUND AND OBJECTIVES: Aerobic exercise is a cost-effective intervention to improve arterial stiffness, but its effects on older people are unclear; this review aimed to determine those effects.

RESEARCH DESIGN AND METHODS: Five databases were searched for randomized controlled trials of aerobic exercises. Backward and forward citations and clinical trial registries were also reviewed. Data were extracted and synthesized. A random-effects model was used in a meta-analysis. The risk of bias and the certainty of the evidence were also assessed. The protocol of this review was registered (CRD42022349494).

RESULTS: Eighteen studies (n=775), were identified. Aerobic exercises included cycling, walking, swimming, standing core exercise, bench step exercise, aquarobic exercise, jogging, running, upper-limb cycling, and aquatic walking. Post-intervention, improvements were seen in the pulse wave velocity (SMD9=-0.89, 95% CI -1.57 to -0.22), arterial velocity-pulse index (MD2=-6.84, 95% CI -9.05 to -4.63), and arterial pressure-volume index (MD2=-4.97, 95% CI -6.9 to -3.04), but not in the augmentation index, arterial compliance, or beta-stiffness index. Exercise lasting >8 weeks but not 4-8 weeks significantly improved pulse wave velocity. Aerobic exercise had a beneficial effect on healthy older people but not on older people with disease. The overall risk of bias was high in nine of the included studies, with some concerns in the remaining studies. The certainty of the evidence was very low.

DISCUSSION AND IMPLICATIONS: Aerobic exercises, particularly those lasting >8 weeks, appear to be effective at improving pulse wave velocity in older people post-intervention. Future trials with robust designs are needed.