Effect of Exercise Intervention on Flow-Mediated Dilation in Overweight and Obese Adults: Meta-Analysis

Overview

Journal Int J Vasc Med

Publisher Wiley

Specialty Cardiology & Vascular Diseases

Date 2017 Nov 4

PMID 29098086

Citations 14

Authors

Younsun Son

Kyungun Kim

Soeun Jeon

Minsoo Kang

Sukho Lee

Yoonjung Park

Affiliations

Soon will be listed here.

Abstract

The objective of this meta-analysis is to summarize the effect of exercise intervention on flow-mediated dilatation (FMD) in overweight and obese adults. We searched four electronic databases (PubMed/Medline, Scopus, and CINAHL) through June 2016 for relevant studies pertaining to the effectiveness of exercise intervention on FMD. Seventeen of the 91 studies identified met the inclusion criteria. Comprehensive Meta-Analysis software (version 3) was used to compute the standardized mean difference effect size (ES) and 95% CI using a random effects model. We calculated 34 ESs. We found that exercise intervention had medium and positive effects on FMD, with an overall ES of 0.522 (95% CI = 0.257, 0.786). Heterogeneity of ESs was observed ( = 239, ≤ 0.001, = 86.19), and the effect was moderated by comorbidity ( = 6.39, df = 1, = 0.011). A large ES for the combination exercise, low intensity exercise, and comorbidity subgroups (ES = 0.82~1.24) was found. We conclude that while exercise intervention significantly improves FMD in overweight and obese adults, the effect may depend on the different characteristics of exercise intervention and on participants' demographics.

Citing Articles

Spirituality-Based Intervention in Hypertension: EFfects on Blood PrEssure and EndotheliaL Function-FEEL Trial Results.

Teixeira M, Barroso W, Brandao A, Sousa A, Esporcatte R, de Borba M Glob Heart. 2025; 20(1):6.

PMID: 39867664 PMC: 11759529. DOI: 10.5334/gh.1390.

Effects of Singing on Vascular Health in Older Adults with Coronary Artery Disease: A Randomized Trial.

Bagherimohamadipour M, Hammad M, Visotcky A, Sparapani R, Kulinski J medRxiv. 2024; .

PMID: 39108506 PMC: 11302710. DOI: 10.1101/2024.07.25.24311033.

Obesity does not alter vascular function and handgrip exercise hemodynamics in middle-aged patients with hypertension.

Ratchford S, Broxterman R, LA Salle D, Kwon O, Hopkins P, Richardson R Am J Physiol Regul Integr Comp Physiol. 2023; 326(1):R1-R9.

PMID: 37842741 PMC: 11283903. DOI: 10.1152/ajpregu.00105.2023.

Effect of aerobic and resistance exercise training on endothelial function in individuals with overweight and obesity: a systematic review with meta-analysis of randomized clinical trials.

Cortes M, da Silva R, de Oliveira P, da Silva D, Irigoyen M, Waclawovsky G Sci Rep. 2023; 13(1):11826.

PMID: 37479727 PMC: 10362025. DOI: 10.1038/s41598-023-38603-x.

Effects and Optimal Dose of Exercise on Endothelial Function in Patients with Heart Failure: A Systematic Review and Meta-Analysis.

Fuertes-Kenneally L, Manresa-Rocamora A, Blasco-Peris C, Ribeiro F, Sempere-Ruiz N, Sarabia J Sports Med Open. 2023; 9(1):8.

PMID: 36739344 PMC: 9899305. DOI: 10.1186/s40798-023-00553-z.

References

Cotie L, Josse A, Phillips S, MacDonald M . Endothelial function increases after a 16-week diet and exercise intervention in overweight and obese young women. Biomed Res Int. 2014; 2014:327395. PMC: 3977448. DOI: 10.1155/2014/327395. View

Phillips S, Das E, Wang J, Pritchard K, Gutterman D . Resistance and aerobic exercise protects against acute endothelial impairment induced by a single exposure to hypertension during exertion. J Appl Physiol (1985). 2011; 110(4):1013-20. PMC: 3075126. DOI: 10.1152/japplphysiol.00438.2010. View

Phillips S, Mahmoud A, Brown M, Haus J . Exercise interventions and peripheral arterial function: implications for cardio-metabolic disease. Prog Cardiovasc Dis. 2014; 57(5):521-34. DOI: 10.1016/j.pcad.2014.12.005. View

Thijssen D, Black M, Pyke K, Padilla J, Atkinson G, Harris R . Assessment of flow-mediated dilation in humans: a methodological and physiological guideline. Am J Physiol Heart Circ Physiol. 2010; 300(1):H2-12. PMC: 3023245. DOI: 10.1152/ajpheart.00471.2010. View

Maher C, Sherrington C, Herbert R, Moseley A, Elkins M . Reliability of the PEDro scale for rating quality of randomized controlled trials. Phys Ther. 2003; 83(8):713-21. View

Olson T, Dengel D, Leon A, Schmitz K . Moderate resistance training and vascular health in overweight women. Med Sci Sports Exerc. 2006; 38(9):1558-64. DOI: 10.1249/01.mss.0000227540.58916.0e. View

Fayh A, Lopes A, da Silva A, Reischak-Oliveira A, Friedman R . Effects of 5 % weight loss through diet or diet plus exercise on cardiovascular parameters of obese: a randomized clinical trial. Eur J Nutr. 2012; 52(5):1443-50. DOI: 10.1007/s00394-012-0450-1. View

Pugh C, Spring V, Kemp G, Richardson P, Shojaee-Moradie F, Umpleby A . Exercise training reverses endothelial dysfunction in nonalcoholic fatty liver disease. Am J Physiol Heart Circ Physiol. 2014; 307(9):H1298-306. DOI: 10.1152/ajpheart.00306.2014. View

de Morton N . The PEDro scale is a valid measure of the methodological quality of clinical trials: a demographic study. Aust J Physiother. 2009; 55(2):129-33. DOI: 10.1016/s0004-9514(09)70043-1. View

10.

Hajjar D, Gotto Jr A . Biological relevance of inflammation and oxidative stress in the pathogenesis of arterial diseases. Am J Pathol. 2013; 182(5):1474-81. PMC: 3644714. DOI: 10.1016/j.ajpath.2013.01.010. View

11.

Poirier P, Giles T, Bray G, Hong Y, Stern J, Pi-Sunyer F . Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss: an update of the 1997 American Heart Association Scientific Statement on Obesity and Heart Disease from the Obesity Committee of the Council on Nutrition,.... Circulation. 2005; 113(6):898-918. DOI: 10.1161/CIRCULATIONAHA.106.171016. View

12.

Harris R . FMD, reproducibility, and acute exercise in the obese: are the results confounded?. Eur J Appl Physiol. 2010; 109(2):357-8. DOI: 10.1007/s00421-009-1343-8. View

13.

Choo J, Lee J, Cho J, Burke L, Sekikawa A, Jae S . Effects of weight management by exercise modes on markers of subclinical atherosclerosis and cardiometabolic profile among women with abdominal obesity: a randomized controlled trial. BMC Cardiovasc Disord. 2014; 14:82. PMC: 4105524. DOI: 10.1186/1471-2261-14-82. View

14.

Moher D, Liberati A, Tetzlaff J, Altman D . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009; 339:b2535. PMC: 2714657. DOI: 10.1136/bmj.b2535. View

15.

Jurva J, Phillips S, Syed A, Syed A, Pitt S, Weaver A . The effect of exertional hypertension evoked by weight lifting on vascular endothelial function. J Am Coll Cardiol. 2006; 48(3):588-9. DOI: 10.1016/j.jacc.2006.05.004. View

16.

Bender S, Laughlin M . Modulation of endothelial cell phenotype by physical activity: impact on obesity-related endothelial dysfunction. Am J Physiol Heart Circ Physiol. 2015; 309(1):H1-8. PMC: 4491515. DOI: 10.1152/ajpheart.00177.2015. View

17.

Blumenthal J, Babyak M, Hinderliter A, Watkins L, Craighead L, Lin P . Effects of the DASH diet alone and in combination with exercise and weight loss on blood pressure and cardiovascular biomarkers in men and women with high blood pressure: the ENCORE study. Arch Intern Med. 2010; 170(2):126-35. PMC: 3633078. DOI: 10.1001/archinternmed.2009.470. View

18.

Ashor A, Lara J, Siervo M, Celis-Morales C, Oggioni C, Jakovljevic D . Exercise modalities and endothelial function: a systematic review and dose-response meta-analysis of randomized controlled trials. Sports Med. 2014; 45(2):279-96. DOI: 10.1007/s40279-014-0272-9. View

19.

Flores L, Nunez I, Vidal J, Rueda S, Viaplana J, Rodriguez L . Endothelial function in hypertensive obese patients: 1 year after surgically induced weight loss. Obes Surg. 2014; 24(9):1581-4. DOI: 10.1007/s11695-014-1328-5. View

20.

Stapleton P, James M, Goodwill A, Frisbee J . Obesity and vascular dysfunction. Pathophysiology. 2008; 15(2):79-89. PMC: 2593649. DOI: 10.1016/j.pathophys.2008.04.007. View