Low-to-Moderate-Intensity Resistance Exercise Is More Effective than High-Intensity at Improving Endothelial Function in Adults: A Systematic Review and Meta-Analysis

Abstract

Aerobic exercise has been confirmed to improve endothelial function (EF). However, the effect of resistance exercise (RE) on EF remains controversial. We conducted this systematic review and meta-analysis on randomized controlled trials (RCTs) to determine the effect of RE and its intensities on EF. We searched Web of Science, PubMed/MEDLINE, Scopus, and Wiley Online Library, and included 15 articles (17 trials) for the synthesis. Overall, RE intervention significantly improved flow-mediated dilatation (FMD) in brachial artery (SMD = 0.76; 95% CI: 0.47, 1.05; p < 0.00001), which represents improved EF. Meta-regression showed that the RE intensity was correlated with changes in FMD (Coef. = −0.274, T = −2.18, p = 0.045). We found both intensities of RE improved FMD, but the effect size for the low- to moderate-intensity (30–70%1RM) was bigger (SMD = 1.02; 95% CI: 0.60, 1.43; p < 0.0001) than for the high-intensity (≥70%1RM; SMD = 0.48; 95% CI: 0.21, 0.74; p = 0.005). We further noticed that RE had a beneficial effect (SMD = 0.61; 95% CI: 0.13, 1.09; p = 0.01) on the brachial artery baseline diameter at rest (BADrest), and the age variable was correlated with the changes in BADrest after RE (Coef. = −0.032, T = −2.33, p = 0.038). Young individuals (<40 years) presented with a bigger effect size for BADrest (SMD = 1.23; 95% CI: 0.30,2.15; p = 0.009), while middle-aged to elderly (≥40 years) were not responsive to RE (SMD = 0.07; 95% CI: −0.28, 0.42; p = 0.70). Based on our findings, we conclude that RE intervention can improve the EF, and low- to moderate-intensity is more effective than high-intensity.

Efeitos agudos do exercício contrarresistência com restrição de fluxo sanguíneo na função endotelial e agregação plaquetária

“…It is important to note that we used an exercise protocol involving only lower limbs in the present study. However, earlier studies have indicated that vascular responses to exercise may also be evident in arteries not directly feeding the active skeletal muscle, with evident changes in brachial artery FMD following lower limb exercises [29].…”

“…Endothelial dysfunction is an important variable involved in cardiovascular morbidities such as atherosclerosis, hypertension, and coronary artery disease [1]. It has been shown that resistance exercise (RE) can improve endothelial function in adults [2]. Nevertheless, despite favorable long-term adaptations to training, a single RE bout can transiently worsen endothelial function and increases platelet aggregation during and soon after an individual takes part in an exercise session [3].…”

Effects of Differences in Exercise Programs With Regular Resistance Training on Resting Blood Pressure in Hypertensive Adults: A Systematic Review and Meta-Analysis

“…Several factors contribute to changes in RBP as a result of regular exercise (3). Improvements in the vascular function are considered to be one factor, and differences in exercise programs involving RT may specifically act on the vascular function (4,5,7,22,24,34). Based on a subgroup analysis, a recent systematic review and meta-analysis reported that RCTs involving regular RT at 40-65% 1RM resulted in significantly greater improvement in flow-mediated dilation than those at 70-80% 1RM (34).…”

“…Furthermore, because no meta-analyses have examined the effects of RT in hypertensive adults while considering load, number of repetitions, number of sets, and weekly frequency, the current study focused on how differences in exercise programs affected RBP. Few systematic reviews and meta-analyses have indicated that effects on outcomes such as the vascular function and glucose metabolism differed according to RT exercise programs (1,5,34). Because the improvement of those outcomes is a factor causing a decrease in RBP (3), the change in RBP may also depend on differences in RT exercise programs.…”

Exercise, Erectile Dysfunction and Co-Morbidities: “The Good, the Bad and the Ugly”

“…Regarding resistance training, it has been shown that it produces a significant improvement in endothelial function, regardless of a history of cardiovascular or chronic metabolic disease [79]. Low-to moderateintensity resistance training program seems to be more efficacious in improving endothelial function, compared to high-intensity [80]. Improvement in endothelial function may be more pronounced in patients with type 2 DM compared to non-diabetic subjects [81].…”