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. (C) 2014 Elsevier Ireland Ltd. All rights reserved.