The Effect of Aerobic Exercises on Arterial Stiffness in Older People: A Systematic Review and Meta-Analysis

Background and Objectives: Aerobic exercise is a cost-effective intervention to improve arterial stiffness, but its effects on older people are unclear; this review aims to determine those effects. Research Design and Methods: Five databases were searched for randomized controlled trials of aerobic exercises. Backward and forward citations and clinical trial registries were also reviewed. Data were extracted and synthesized. A random-effects model was used in a meta-analysis. The risk of bias and the certainty of the evidence were also assessed. The protocol of this review was registered (PROSPERO registration number: CRD42022349494). Results: Eighteen studies (n = 775) were identified. Aerobic exercises included cycling, walking, swimming, standing core exercise, bench step exercise, aquarobic exercise, jogging, running, upper-limb cycling, and aquatic walking. Postintervention, improvements were seen in the pulse wave velocity (SMD₉ = −0.89, 95% confidence interval (CI)–1.57 to –0.22), arterial velocity–pulse index (MD₂ = –6.84, 95% CI –9.05 to –4.63), and arterial pressure–volume index (MD₂ = –4.97, 95% CI –6.9 to –3.04), but not in the augmentation index, arterial compliance, or beta stiffness index. Exercise lasting >8 weeks but not 4–8 weeks significantly improved pulse wave velocity. Aerobic exercise had a beneficial effect on healthy older people but not on older people with disease. The overall risk of bias was high in 9 of the included studies, with some concerns in the remaining studies. The certainty of the evidence was very low. Discussion and Implications: Aerobic exercises, particularly those lasting >8 weeks, appear to be effective at improving pulse wave velocity in older people postintervention. Future trials with robust designs are needed.