Impact of exercise training on pulse wave velocity in healthy and clinical populations: a systematic review of systematic reviews

Abstract

Elevated pulse wave velocity (PWV) determined arterial stiffness is a prominent marker of cardiovascular disease (CVD) risk. Exercise training delays the progression of CVD, but existing reviews on the impact of training on PWV are conflicting. We synthesized the evidence on the effects of exercise training interventions on PWV. We searched Scopus, EMBASE, PubMed, CINAHL, and Academic Search Premier databases for systematic reviews including PWV, and examined the effects of exercise training on PWV. 842 citations were screened which resulted in 44 systematic reviews, including 22 meta-analyses [unique participants n=6719 (3390 females)]. Studies were conducted in general adults with/without disease(s) ( n=19, 8 meta-analyses), kidney disease ( n=9, 6 meta-analyses), increased CVD risk or CVD ( n=7, 5 meta-analyses), type 2 diabetes mellitus ( n=3, 2 meta-analyses), and other conditions ( n=6, 2 meta-analyses). In general adults, PWV was reduced by aerobic exercise (β:-0.75 to -0.52 m/s) and low-to-moderate intensity resistance exercise training (β:-0.34 m/s). Exercise training was beneficial for patients with kidney disease (β:-1.13 to -0.56 m/s). Aerobic exercise improved PWV in adults with CVD or high CVD risk (β:-0.70 to -0.42 m/s). Combined aerobic and resistance exercise training decreased carotid-femoral PWV in patients with CVD (β:-1.15 m/s) and decreased brachial-ankle PWV in post-menopausal females (β:-1.18 m/s). Neither aerobic nor combined training improved PWV in individuals with type 2 diabetes. The potential physiological mechanisms involved are discussed. Overall, the included systematic reviews and meta-analyses documented that exercise training was an effective strategy to improve PWV, but the optimal type of training varied between populations.