Effect of aerobic exercise training on pulse wave velocity in adults with and without long-term conditions: a systematic review and meta-analysis
Thomas Yates,
Michael C Steiner,
Gerry P McCann,
Amy V Jones,
Enya Daynes,
Lorna Latimer,
Matt Graham-Brown,
Pip Divall,
Majda Bakali,
Thomas CJ Ward,
Grace M Hawthorne,
Rachael Andrea Evans
Affiliations
Thomas Yates
Diabetes Research Centre, University of Leicester, Leicester, UK
Michael C Steiner
NIHR Leicester Biomedical Research Centre –Respiratory, Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
Gerry P McCann
Department of Cardiovascular Sciences and NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
Amy V Jones
Centre of Exercise and Reshabilitaiton Sciences, NIHR Leicester Biomedical Research Centre, Leicester, UK
Enya Daynes
CERS, NIHR Leicester Biomedical Research Centre, Leicester, UK
Lorna Latimer
NIHR Leicester Biomedical Research Centre –Respiratory, Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
Matt Graham-Brown
Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
Pip Divall
Education Centre Library, University Hospitals of Leicester NHS Trust, Leicester, UK
Majda Bakali
NIHR Leicester Biomedical Research Centre –Respiratory, Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
Thomas CJ Ward
NIHR Leicester Biomedical Research Centre –Respiratory, Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
Grace M Hawthorne
Centre of Exercise and Reshabilitaiton Sciences, NIHR Leicester Biomedical Research Centre, Leicester, UK
Rachael Andrea Evans
NIHR Leicester Biomedical Research Centre –Respiratory, Department of Respiratory Sciences, College of Life Sciences, University of Leicester, Leicester, UK
Rationale There is conflicting evidence whether aerobic exercise training (AET) reduces pulse wave velocity (PWV) in adults with and without long-term conditions (LTCs).Objective To explore whether PWV improves with AET in adults with and without LTC, to quantify the magnitude of any effect and understand the influence of the exercise prescription.Data sources CENTRAL, MEDLINE and EMBASE were among the databases searched.Eligibility criteria We included studies with a PWV measurement before and after supervised AET of at least 3 weeks duration. Exclusion criteria included resistance exercise and alternative measures of arterial stiffness.Design Controlled trials were included in a random effects meta-analysis to explore the effect of AET on PWV. Uncontrolled studies were included in a secondary meta-analysis and meta-regression exploring the effect of patient and programme factors on change in PWV. The relevant risk of bias tool was used for each study design.Results 79 studies (n=3729) were included: 35 controlled studies (21 randomised control trials (RCT) (n=1240) and 12 non-RCT (n=463)) and 44 uncontrolled (n=2026). In the controlled meta- analysis, PWV was significantly reduced following AET (mean (SD) 11 (7) weeks) in adults with and without LTC (mean difference −0.63; 95% CI −0.82 to −0.44; p<0.0001). PWV was similarly reduced between adults with and without LTC (p<0.001). Age, but not specific programme factors, was inversely associated with a reduction in PWV −0.010 (−0.020 to −0.010) m/s, p<0.001.Discussion Short-term AET similarly reduces PWV in adults with and without LTC. Whether this effect is sustained and the clinical implications require further investigation.
