The effect of resistance training on endothelial function in young and older with chronic diseases and those with health conditions: a systematic review and meta-analysis

Document Type : review article

Authors

1 Department of Physical Education and Sports Sciences, Faculty of Humanities, University of Kashan, Kashan, Iran

2 Department of Sports Physiology, Faculty of Physical Education and Sports Sciences, University of Tehran, Tehran, Iran

3 Department of Physical Education and Sports Science, School of Psychology and Educational Sciences, Yazd University, Yazd, Iran

4 Department of Cell and Molecular Biology Faculty, Science and Research Branch, Islamic Azad University، Tehran, Iran

Abstract

Background and Purpose: Endothelial dysfunction plays an important role in the development of cardiovascular diseases. Exercise training may lead to improved endothelial function. However, the effect of resistance training on endothelial function is not clearly understood. In addition, the age and health status of individuals may also play a role in endothelial function, and these factors have not been investigated in endothelial response to resistance training. Therefore, the aim of the present meta-analysis is to investigate the effect of resistance training on endothelial function in young and older adults with and without chronic diseases.
Materials and Methods: Main databases including PubMed and Web of Science were searched through January 13, 2023, for resistance training studies on the FMD index. The inclusion criteria for the current research included studies with an exercise training group, human subjects with an average age older than 18 years, measuring endothelial function using FMD, and published in English and Persian language journals. Weighted mean difference (WMD) and 95% confidence interval were used to determine the effect size using CMA2 software. The level of heterogeneity was assessed using the I2 test and the publication bias was also assessed with Egger's test. Subgroup analyses were performed for age (elderly adults including people over 50 years old and young adults including people under 50 years old), health status (with chronic disease and healthy), and type of study (one-group and two-group). All analyzes were performed using CMA2 software.
Results: Twenty-one studies including 701 participants were included in the meta-analysis. The results of data analysis showed that resistance training resulted in a significant increase in FMD [2.07, (CI: 1.26 to 2.88) P = 0.001]. Examination of heterogeneity using the I2 test showed that there was a significant heterogeneity (I2=82.92, p=0.001), while Egger's test results (p=0.73) did not confirm the publication bias. Subgroup analysis based on age showed that resistance training in both groups of young [WMD: 2.06, P = 0.001] and older [WMD: 1.87, P = 0.001] individuals leads to an increase in FMD. In addition, resistance training in both groups of healthy [WMD: 1.770 P = 0.001] and patients [WMD: 2.406 P = 0.001] individuals lead to an increase in FMD. In addition, the analysis based on the type of study showed that FMD is increased in both single-group [WMD: 1.18, P = 0.029] and two-group [WMD:2.51, P  =0.001] studies.
Conclusion: In general, the main findings of the present meta-analysis show that resistance training is an effective exercise intervention for improving endothelial function, whose beneficial effects occur independently of the age and health status of adults. Therefore, resistance training should be included in the exercise program for adults.
 

Keywords

Main Subjects


  1. Shimokawa H. 2014 Williams Harvey Lecture: importance of coronary vasomotion abnormalities—from bench to bedside. European Heart Journal. 2014;35(45):3180-93.
  2. Vanhoutte P, Shimokawa H, Feletou M, Tang E. Endothelial dysfunction and vascular disease–a 30th anniversary update. Acta physiologica. 2017;219(1):22-96.
  3. Paditsaeree K, Mitranun W. Does combining elastic and weight resistance acutely protect against the impairment of flow-mediated dilatation in untrained men? Artery Research. 2018;23:1-8.
  4. Silva JKT, Menêses AL, Parmenter BJ, Ritti-Dias RM, Farah BQ. Effects of resistance training on endothelial function: a systematic review and meta-analysis. Atherosclerosis. 2021;333:91-9.
  5. Khalafi M, Mojtahedi S, Ostovar A, Rosenkranz SK, Korivi M. High‐intensity interval exercise versus moderate‐intensity continuous exercise on postprandial glucose and insulin responses: A systematic review and meta‐analysis. Obesity Reviews. 2022:e13459.
  6. Khalafi M, Ravasi AA, Malandish A, Rosenkranz SK. The impact of high-intensity interval training on postprandial glucose and insulin: A systematic review and meta-analysis. Diabetes Research and Clinical Practice. 2022:109815.
  7. Khalafi M, Sakhaei MH, Kazeminasab F, Symonds ME, Rosenkranz SK. The impact of high-intensity interval training on vascular function in adults: A systematic review and meta-analysis. Frontiers in Cardiovascular Medicine. 2022:1.
  8. Khalafi M, Sakhaei MH, Kheradmand S, Symonds ME, Rosenkranz SK. The impact of exercise and dietary interventions on circulating leptin and adiponectin in individuals with overweight and obesity: a systematic review and meta-analysis. Advances in Nutrition. 2022.
  9. Nouri-habashi A, Ahmadizad S, Salimian M, Rahmani H. The effects of high intensity interval training on platelet aggregation and phosphorylation of VASPser239 in men with coronary heart disease. Journal of Sport and Exercise Physiology. 2018;11(2):49-62. (In Persian)
  10. Moradian H, Hosseinpour Delavar S, Zabet A. The effects of eight weeks circuit resistance training on some endothelial markers, blood pressure and lipid profiles in pre-hypertensive obese women. Journal of Sport and Exercise Physiology. 2022;15(2):84-94. (In Persian)
  11. Shiotsu Y, Watanabe Y, Tujii S, Yanagita M. Effect of exercise order of combined aerobic and resistance training on arterial stiffness in older men. Experimental gerontology. 2018;111:27-34.
  12. Figueroa A, Okamoto T, Jaime SJ, Fahs CA. Impact of high-and low-intensity resistance training on arterial stiffness and blood pressure in adults across the lifespan: a review. Pflügers Archiv-European Journal of Physiology. 2019;471(3):467-78.
  13. Pedralli ML, Eibel B, Waclawovsky G, Schaun MI, Nisa-Castro-Neto W, Umpierre D, et al. Effects of exercise training on endothelial function in individuals with hypertension: a systematic review with meta-analysis. Journal of the American Society of Hypertension. 2018;12(12):e65-e75.
  14. Pedralli ML, Marschner RA, Kollet DP, Neto SG, Eibel B, Tanaka H, et al. Different exercise training modalities produce similar endothelial function improvements in individuals with prehypertension or hypertension: A randomized clinical trial. Scientific reports. 2020;10(1):1-9.
  15. Feigenbaum MS, Pollock ML. Prescription of resistance training for health and disease. Medicine and science in sports and exercise. 1999;31(1):38-45.
  16. Polito MD, Dias Jr JR, Papst RR. Resistance training to reduce resting blood pressure and increase muscle strength in users and non-users of anti-hypertensive medication: A meta-analysis. Clinical and Experimental Hypertension. 2021;43(5):474-85.
  17. Phillips MD, Patrizi RM, Cheek DJ, Wooten JS, Barbee JJ, Mitchell JB. Resistance training reduces subclinical inflammation in obese, postmenopausal women. Medicine & Science in Sports & Exercise.2012;44(11) :2099-110.
  18. Khalafi M, Malandish A, Rosenkranz SK, Ravasi AA. Effect of resistance training with and without caloric restriction on visceral fat: A systemic review and meta‐analysis. Obesity Reviews. 2021;22(9):e13275.
  19. Boidin M, Erskine RM, Thijssen DH, Dawson EA. Exercise modality, but not exercise training, alters the acute effect of exercise on endothelial function in healthy men. Journal of Applied Physiology. 2021;130(6):1716-23.
  20. Casey DP, Pierce GL, Howe KS, Mering MC, Braith Effect of resistance training on arterial wave reflection and brachial artery reactivity in normotensive postmenopausal women. European journal of applied physiology. 2007;100(4):403-8.
  21. Miyachi M, Kawano H, Sugawara J, Takahashi K, Hayashi K, Yamazaki K, et al. Unfavorable effects of resistance training on central arterial compliance: a randomized intervention study. Circulation. 2004;110(18):2858-63.
  22. Dawson EA, Sheikhsaraf B, Boidin M, Erskine RM, Thijssen DH. Intra‐individual differences in the effect of endurance versus resistance training on vascular function: A cross‐over study. Scandinavian Journal of Medicine & Science in Sports. 2021;31(8):1683-92.
  23. Rueda-Clausen CF, Lahera V, Calderón J, Bolivar IC, Castillo VR, Gutiérrez M, et al. The presence of abdominal obesity is associated with changes in vascular function independently of other cardiovascular risk factors. International journal of cardiology. 2010;139(1):32-41.
  24. Baron AD. Insulin resistance and vascular function. Journal of Diabetes and its Complications. 2002;16(1):92-102.
  25. Novo G, Manno G, Russo R, Buccheri D, Dell'Oglio S, Morreale P, et al. Impact of insulin resistance on cardiac and vascular function. International Journal of Cardiology. 2016;221:1095-9.
  26. Seals DR, Jablonski KL, Donato AJ. Aging and vascular endothelial function in humans. Clinical science. 2011;120(9):357-75.
  27. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. International journal of surgery. 2021;88:105906.
  28. De Morton NA. The PEDro scale is a valid measure of the methodological quality of clinical trials: a demographic study. Australian Journal of Physiotherapy. 2009;55(2):129-33.
  29. Allen JD, Geaghan JP, Greenway F, Welsch MA. Time course of improved flow-mediated dilation after short-term exercise training. Medicine and science in sports and exercise. 2003;35(5):847-53.
  30. Almenning I, Rieber-Mohn A, Lundgren KM, Shetelig Løvvik T, Garnaes KK, Moholdt T. Effects of high intensity interval training and strength training on metabolic, cardiovascular and hormonal outcomes in women with polycystic ovary syndrome: a pilot study. Plos one. 2015;10(9):e0138793.
  31. Beck DT, Casey DP, Martin JS, Emerson BD, Braith RW. Exercise training improves endothelial function in young prehypertensives. Experimental biology and medicine. 2013;238(4):433-41.
  32. Boeno FP, Ramis TR, Munhoz SV, Farinha JB, Moritz CE, Leal-Menezes R, et al. Effect of aerobic and resistance exercise training on inflammation, endothelial function and ambulatory blood pressure in middle-aged hypertensive patients. Journal of Hypertension. 2020;38(12):2501-9.
  33. Correia M, Oliveira PL, Farah BQ, Vianna LC, Wolosker N, Puech‐Leao P, et al. Effects of isometric handgrip training in patients with peripheral artery disease: a randomized controlled trial. Journal of the American Heart Association. 2020;9(4):e013596.
  34. Early KS, Rockhill M, Bryan A, Tyo B, Buuck D, McGinty J. Effect of blood flow restriction training on muscular performance, pain and vascular function. International journal of sports physical therapy. 2020;15(6):892.
  35. Hildreth KL, Schwartz RS, Vande Griend J, Kohrt WM, Blatchford PJ, Moreau KL. Effects of testosterone and progressive resistance exercise on vascular function in older men. Journal of Applied Physiology. 2018;125(6):1693-701.
  36. Jaime SJ, Maharaj A, Alvarez-Alvarado S, Figueroa A. Impact of low-intensity resistance and whole-body vibration training on aortic hemodynamics and vascular function in postmenopausal women. Hypertension Research. 2019;42(12):1979-88.
  37. Javidi M, Ahmadizad S, Argani H, Najafi A, Ebrahim K, Salehi N, et al. Effect of Lower-versus Higher-Intensity Isometric Handgrip Training in Adults with Hypertension: A Randomized Controlled Trial. Journal of Cardiovascular Development and Disease. 2022;9(9):287.
  38. Kwon HR, Min KW, Ahn HJ, Seok HG, Lee JH, Park GS, et al. Effects of aerobic exercise vs. resistance training on endothelial function in women with type 2 diabetes mellitus. Diabetes & metabolism journal. 2011;35(4):364-73.
  39. Lekavich CL, Allen JD, Bensimhon DR, Bateman LA, Slentz CA, Samsa GP, et al. Aerobic versus resistance training effects on ventricular-arterial coupling and vascular function in the STRRIDE-AT/RT trial. Frontiers in Cardiovascular Medicine. 2021;8:638929.
  40. McDermott MM, Ades P, Guralnik JM, Dyer A, Ferrucci L, Liu K, et al. Treadmill exercise and resistance training in patients with peripheral arterial disease with and without intermittent claudication: a randomized controlled trial. Jama. 2009;301(2):165-74.
  41. McGowan CL, Levy AS, McCartney N, MacDonald MJ. Isometric handgrip training does not improve flow-mediated dilation in subjects with normal blood pressure. Clinical Science. 2007;112(7):403-9.
  42. O'Brien MW, Johns JA, Robinson SA, Bungay A, Mekary S, Kimmerly DS. Impact of High-Intensity Interval Training, Moderate-Intensity Continuous Training, and Resistance Training on Endothelial Function in Older Adults. Medicine and science in sports and exercise. 2020;52(5):1057-67.
  43. Okamoto T, Masuhara M, Ikuta K. Effect of low-intensity resistance training on arterial function. European Journal of Applied Physiology. 2011;111(5):743-8.
  44. Olson TP, Dengel DR, Leon AS, Schmitz KH. Moderate resistance training and vascular health in overweight women. Medicine & Science in Sports & Exercise. 2006;38(9):1558-64.
  45. Spence AL, Carter HH, Naylor LH, Green DJ. A prospective randomized longitudinal study involving 6 months of endurance or resistance exercise. Conduit artery adaptation in humans. The Journal of physiology. 2013;591(5):1265-75.
  46. Stensvold D, Tjønna AE, Skaug E-A, Aspenes S, Stølen T, Wisløff U, et al. Strength training versus aerobic interval training to modify risk factors of metabolic syndrome. Journal of applied physiology. 2010;108(4):804-10.
  47. Vona M, Codeluppi G, Iannino T, Ferrari E, Bogousslavsky J, Von Segesser L. Effects of different types of exercise training followed by detraining on endothelium-dependent dilation in patients with recent myocardial infarction. Circulation. 2009;119(12):1601-8.
  48. Casey DP, Pierce GL, Howe KS, Mering MC, Braith RW. Effect of resistance training on arterial wave reflection and brachial artery reactivity in normotensive postmenopausal women. European journal of applied physiology. 2007;100:403-8.
  49. Allen JD, Geaghan JP, Greenway F, Welsch MA. Time course of improved flow-mediated dilation after short-term exercise training. Medicine & Science in Sports & Exercise. 2003;35(5):847-53.
  50. Okamoto T, Masuhara M, Ikuta K. Effect of low-intensity resistance training on arterial function. European Journal of Applied Physiology. 2011;111:743-8.
  51. Xu Y, Arora RC, Hiebert BM, Lerner B, Szwajcer A, McDonald K, et al. Non-invasive endothelial function testing and the risk of adverse outcomes: a systematic review and meta-analysis. European Heart Journal–Cardiovascular Imaging. 2014;15(7):736-46.
  52. Brislane Á, Sculthorpe NF, Davenport MH, Beaumont A. Exercise training and vascular function in postmenopausal individuals: a systematic review and meta-analysis. Menopause. 2022;29(8):982-92.
  53. Knapp TR. Why is the one-group pretest–posttest design still used?: SAGE Publications Sage CA: Los Angeles, CA; 2016. p. 467-72.
  54. Craighead DH, Heinbockel TC, Hamilton MN, Bailey EF, MacDonald MJ, Gibala MJ, et al. Time-efficient physical training for enhancing cardiovascular function in midlife and older adults: promise and current research gaps. Journal of Applied Physiology. 2019;127(5):1427-40.
  55. Ogawa K, Sanada K, Machida S, Okutsu M, Suzuki K. Resistance exercise training-induced muscle hypertrophy was associated with reduction of inflammatory markers in elderly women. Mediators of 2010;2010.
  56. Parise G, Brose AN, Tarnopolsky MA. Resistance exercise training decreases oxidative damage to DNA and increases cytochrome oxidase activity in older adults. Experimental gerontology. 2005;40(3):173-80.
  57. Maeda S, Otsuki T, Iemitsu M, Kamioka M, Sugawara J, Kuno S, et al. Effects of leg resistance training on arterial function in older men. British journal of sports medicine. 2006;40(10):867-9.
  • Receive Date: 04 March 2023
  • Revise Date: 06 May 2023
  • Accept Date: 08 May 2023
  • First Publish Date: 16 June 2023
  • Publish Date: 22 June 2023