The impact of aerobic exercise training on arterial stiffness in pre- and hypertensive subjects: a systematic review and meta-analysis.
BACKGROUND
Debate concerning aerobic exercise decreasing arterial stiffness in pre- and hypertensive individuals still exists. We sought to systematically review and quantify the effect of aerobic exercise training on arterial stiffness in pre- and hypertensive subjects.


METHODS
MEDLINE, Cochrane, Scopus and Web of Science were searched up until August 2013 for trials assessing the effect of aerobic exercise interventions lasting 4 or more weeks on arterial stiffness in (pre)hypertensive subjects. Standardized mean difference (SMD) in arterial stiffness parameters (PWV, B-stiffness, Compliance, AIx) was calculated using a random-effects model. Subgroup and meta-regression analyses were used to study potential moderating factors.


RESULTS
Fourteen trials comprising a total of 472 (pre)hypertensive subjects met the inclusion criteria. Arterial stiffness was not significantly reduced by aerobic training in (pre)hypertensive subjects (14 trials, SMD=-0.19; P=.06). Likewise, post-intervention arterial stiffness was similar between the aerobic exercise-trained and control (pre)hypertensive subjects (8 trials, SMD=-0.10; P=.43). Neither heterogeneity nor publication bias was detected in either of these analyses. In the subgroup analyses, arterial stiffness was significantly reduced in aerobic exercise-trained (pre)hypertensive subgroups below the median value in post minus pre-intervention systolic blood pressure (SBP) (SMD=-0.38, P=.04) and in subgroups above the median value in the duration of the intervention (SMD=-0.28, P=.03). Similar results were obtained in the meta-regression analysis.


CONCLUSIONS
Arterial stiffness is not reduced in (pre)hypertensive subjects in response to aerobic training unless associated with a substantial reduction in SBP and/or prolonged duration.
Applied Biology Department, Institute of Bioengineering, Miguel Hernandez University, Elche, Spain; Department of Internal Medicine, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands. Electronic address: david.montero.barril@gmail.com.
David
D
Montero
Applied Biology Department, Institute of Bioengineering, Miguel Hernandez University, Elche, Spain.
Enrique
E
Roche
Applied Biology Department, Institute of Bioengineering, Miguel Hernandez University, Elche, Spain.
Alejandro
A
Martinez-Rodriguez
D000818:Animals; D001794:Blood Pressure / Q000502:physiology*; D002986:Clinical Trials as Topic / Q000379:methods; D015444:Exercise / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000503:physiopathology / Q000628:therapy*; D058246:Prehypertension / Q000503:physiopathology / Q000628:therapy*; D059289:Vascular Stiffness / Q000502:physiology*
Aerobic exercise training; Arterial stiffness; Hypertension