| Popis |
Background This study aimed to investigate: (a) the effects of aerobic training (AT) on brachial artery endothelial function, measured by flow-mediated dilatation (baFMD) and whether changes in baFMD are associated with changes in other cardiovascular health markers in healthy adults; (b) whether intra-individual response differences (IIRD) in baFMD improvement exist following AT; and (c) the association between participants’ baseline characteristics and exercise-induced changes in baFMD. Methods The search conducted across six databases (PubMed, Web of Science, CINAHL, EMBASE, the Cochrane Central Register of Controlled Trials, and EBSCOhost) identified 12 eligible studies. We conducted both traditional meta-analyses identifying the effects of the intervention and IIRD. IIRD meta-analysis was performed to assess if true IIRD between AT and the control group exists for baFMD. The methodological quality of included studies was assessed by the PEDro scale, while GRADE assessment was used for certainty of evidence evaluation. Results In total, 12 studies with 385 participants (51% male, 46.3±17.3 [years]) were included in the current review. Meta-analysis revealed improvement in baFMD post-AT (small MD=1.92%, 95% CI 0.90 to 2.94, p=0.001). The standard deviation of change scores in the intervention and control groups suggests that most of the variation in the observed change from pre-to-post intervention is due to other factors (e.g., measurement error, biological variability etc.) unrelated to the intervention itself. However, subgroup meta-analysis revealed that significantly trivial IIRD exists following AT in prehypertensive individuals. Conclusions The study found small improvements in baFMD, suggesting an average 19.2% reduction in cardiovascular disease (CVD) risk, with some individuals—such as prehypertensive individuals—potentially experiencing even greater benefits from AT. However, a meta-analysis based on IIRD suggests that factors unrelated to AT predominantly explain baFMD changes. Further research is needed to better understand response variability in individuals with cardiovascular risk factors, and longer studies are required to assess IIRD in the general population. Key points • In this meta-analysis of 12 randomized controlled trials, aerobic training (AT) intervention revealed small improvements in brachial artery endothelial function measured by flow-mediated dilatation (baFMD) technique in the healthy adult population. • Based on prior evidence indicating that a 1% increase in baFMD is associated with a 10% reduction in cardiovascular disease (CVD) risk, the pooled results demonstrate an average 19.2% decrease in CVD risk following AT. Notably, some individuals may experience even greater benefits from AT. • Conversely, meta-analysis based on intra-individual response difference (IIRD) suggests that factors unrelated to the intervention itself mostly contribute to the observed changes in baFMD, whereas prehypertension appeared to moderate the IIRD in baFMD improvement following AT. • Current evidence indicates that response heterogeneity following AT can be expected in individuals with increased cardiovascular risk factors, such as elevated systolic blood pressure, and this warrants further investigation.
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