title: The Effects of Exercise Training on Brachial Artery Flow-Mediated Dilation: A Meta-analysis.
abstract: OBJECTIVE
  Flow-mediated dilation, a barometer of cardiovascular (CV) health, is reported to increase with exercise training (ET); however, the potential moderating factors of ET are not clear to date. The purpose of this study was to determine the effect of ET assessed by brachial artery flow-mediated dilation (BAFMD).
  
  
  METHODS
  Authors searched PubMed between January 1999 and December 2013, bibliographies, and reviews to identify studies examining ET and BAFMD. Two independent reviewers extracted quality, descriptive, exercise, and outcome data of eligible studies. Data were presented as weighted effect sizes (ESs) and 95% confidence limits.
  
  
  RESULTS
  Analysis included 66 studies reporting BAFMD data (1865 ET and 635 control subjects). Overall, ET had significant improvements in BAFMD compared with controls (P < .0001). Exercise training at higher ET intensities resulted in a greater increase in BAFMD (9.29; 95% CI, 5.09-13.47) than lower ET intensities (3.63; 95% CI, -0.56 to 7.83) or control (-0.42; 95% CI, -2.06 to 1.21). Subjects whose ET duration was ≥150 min/wk (11.33; 95% CI, 7.15-15.51) had a significant improvement in BAFMD compared with those with <150 min/wk (4.79; 95% CI, 3.08-6.51) or control (-0.30; 95% CI, -1.99 to 1.39). Age (P = .11) and baseline artery diameter (P = .31) did not modify the BAFMD response to ET.
  
  
  CONCLUSIONS
  Exercise training contributes to a significant increase in BAFMD. These results provide indirect evidence that ET alters a well-known factor associated with the primary and secondary prevention of CV diseases. Exercise training interventions, including greater intensity and duration, may optimize the increase in BAFMD.
authors.affiliation: School of Kinesiology, Louisiana State University, Baton Rouge (Mss Early and Stewart and Dr Johannsen); Department of Preventive Medicine, Pennington Biomedical Research Center, Baton Rouge, Louisiana (Drs Johannsen and Lavie); John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the University of Queensland School of Medicine, New Orleans, Louisiana (Dr Lavie); College of Education, University of North Texas, Denton (Dr Thomas); and Institute of Sport and Physical Activity Research, University of Bedfordshire, Bedfordshire, United Kingdom (Dr Welsch).
authors.forename: Kate S
authors.initials: KS
authors.lastname: Early
authors.forename: Abigail
authors.initials: A
authors.lastname: Stewart
authors.forename: Neil
authors.initials: N
authors.lastname: Johannsen
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Lavie
authors.forename: Jerry R
authors.initials: JR
authors.lastname: Thomas
authors.forename: Michael
authors.initials: M
authors.lastname: Welsch
mesh_terms: D001916:Brachial Artery / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D012039:Regional Blood Flow / Q000502:physiology*