title: Effect of weight loss induced by energy restriction on measures of arterial compliance: A systematic review and meta-analysis.
abstract: OBJECTIVE
  To conduct a systematic review and meta-analysis of clinical trials involving adults, to determine the effect of weight loss induced by energy restriction with or without exercise, anti-obesity drugs or bariatric surgery on measures of arterial stiffness and compliance.
  
  
  METHODS
  A systematic search of Pubmed, EMBASE, MEDLINE and the Cochrane Library was conducted to find intervention trials (randomised/non-randomised) that aimed to achieve weight loss and included the following outcome measures: cardio-ankle vascular index (CAVI), direct measures of area/diameter related to pressure change (including β-stiffness index, brachial or carotid artery compliance, aortic, carotid or brachial artery distensibility and strain), measures derived from peripheral pulse wave analysis (including augmentation index, augmentation pressure, distal oscillatory, proximal capacitive and systemic compliance) and pulse pressure. Data were analysed using Comprehensive Meta Analysis V2 using random effects analysis. Standardised mean difference (SMD) is reported with negative values indicating an improvement.
  
  
  RESULTS
  A total of 43 studies, involving 4231 participants, were included in the meta-analysis. Mean weight loss was approximately 11% of initial body weight. Weight loss improved CAVI (SMD -0.48; p = 0.04), β-stiffness index (SMD = -0.98; p = 0.001), arterial compliance (SMD = -0.61; p = 0.0001) and distensibility (SMD -1.10; p = 0.005), distal oscillatory compliance (SMD = -0.41; p = 0.03), proximal capacitive compliance (SMD -0.66; p = 0.009), systemic arterial compliance (SMD -0.71; p = 0.003) and reflection time (SMD -0.51; p = 0.001). Augmentation index, strain, augmentation pressure and pulse pressure were not significantly changed with weight loss.
  
  
  CONCLUSIONS
  Weight loss induced by energy restriction improves some measures of arterial compliance and stiffness.
authors: School of Pharmacy and Medical Sciences, University of South Australia, GPO Box 2471, Adelaide, South Australia 5000, Australia; The George Institute for Global Health, University of Sydney, P.O. Box M201 Missenden Road, Camperdown, Sydney, New South Wales 2050, Australia. Electronic address: kristina.petersen@mymail.unisa.edu.au.
authors: K S
authors: KS
authors: Petersen
authors: School of Pharmacy and Medical Sciences, University of South Australia, GPO Box 2471, Adelaide, South Australia 5000, Australia. Electronic address: peter.clifton@unisa.edu.au.
authors: P M
authors: PM
authors: Clifton
authors: School of Pharmacy and Medical Sciences, University of South Australia, GPO Box 2471, Adelaide, South Australia 5000, Australia. Electronic address: natalie.blanch@mymail.unisa.edu.au.
authors: N
authors: N
authors: Lister
authors: School of Pharmacy and Medical Sciences, University of South Australia, GPO Box 2471, Adelaide, South Australia 5000, Australia. Electronic address: jennifer.keogh@unisa.edu.au.
authors: J B
authors: JB
authors: Keogh
mesh_terms: D031204:Caloric Restriction; D003187:Compliance; D004038:Diet, Reducing; D004734:Energy Metabolism; D006801:Humans; D009765:Obesity / Q000150:complications / Q000175:diagnosis / Q000178:diet therapy* / Q000503:physiopathology; D020127:Recovery of Function; D012307:Risk Factors; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D059289:Vascular Stiffness; D015431:Weight Loss
keywords: Arterial compliance; Arterial stiffness; Meta-analysis; Weight loss; Weight reduction