Effects of a 12-Week Resistance Training Program on Arterial Stiffness: A Randomized Controlled Trial

Arterial Stiffness and Wave Reflection Responses Following Heavy and Moderate Load Resistance Training Protocols

This study compared the acute effects of resistance training (RT) between a moderate (ML) and a high loading (HL) intensity (12RM vs. 4RM, respectively), with the same intensity of effort on arterial stiffness and wave reflection in young healthy adults. Eleven healthy adults (age 36.4 ± 6.8 years) performed two RT protocols, ML and HL, in a randomized order. Both RT sessions consisted of three sets of deadlifts and three sets of bench presses, with 2 min rest between sets and exercises. Loading intensity was 12RM and 4RM for the ML and HL conditions, respectively. Measurements of pulse wave velocity (PWV) and pulse wave analysis (PWA; e.g., augmentation index) were collected at baseline, immediately post, and 15 min post-training. ML elicited significantly greater increases in carotid-femoral PWV (from 6.4 ± 0.3 to 7.3 ± 0.5), and augmentation index normalized to 75 bpm (from -5.1 ± 1.1) than HL (all p < 0.05). These findings demonstrate that an acute bout of RT performed to volitional failure using lower loads and higher repetitions impose a greater workload on the arterial and cardiovascular system in comparison to a RT scheme with heavier loads and lower repetitions.

Physical Activity and Arterial Stiffness: A Narrative Review

Arterial stiffness is a significant predictor of cardiovascular disease and mortality. Physical activity (PA) has been extensively studied for its potential to reduce arterial stiffness, but the relationship between different types, durations, and intensities of PA and arterial stiffness remains a topic of ongoing research. Therefore, in this narrative review, we evaluated the current evidence focusing on the effect of PA on arterial stiffness and vascular health and discussed the known underlying physiological mechanisms. PA, irrespective of its intensity or pattern, is consistently associated with lower arterial stiffness. Aerobic exercise, particularly at higher intensities, is the most effective strategy for reducing arterial stiffness. These benefits are especially significant in populations with higher cardiovascular risk, such as those with type 2 diabetes mellitus and hypertension. Therefore, maintaining an active lifestyle into older age is crucial for vascular health and may contribute to healthy aging.

Advanced cardiovascular physiology in an individual with type 1 diabetes after 10-year ketogenic diet

Adults with type 1 diabetes (T1D) have an elevated risk for cardiovascular disease (CVD) compared with the general population. HbA1c is the primary modifiable risk factor for CVD in T1D. Fewer than 1% of patients achieve euglycemia (<5.7% HbA1c). Ketogenic diets (KD; ≤50 g carbohydrate/day) may improve glycemia and downstream vascular dysfunction in T1D by reducing HbA1c and insulin load. However, there are concerns regarding the long-term CVD risk from a KD. Therefore, we compared data collected in a 60-day window in an adult with T1D on exogenous insulin who consumed a KD for 10 years versus normative values in those with T1D (T1D norms). The participant achieved euglycemia with an HbA1c of 5.5%, mean glucose of 98 [5] mg/dL (median [interquartile range]), 90 [11]% time-in-range 70-180 mg/dL (T1D norms: 1st percentile for all), and low insulin requirements of 0.38 ± 0.03 IU/kg/day (T1D norms: 8th percentile). Seated systolic blood pressure (SBP) was 113 mmHg (T1D norms: 18th percentile), while ambulatory awake SBP was 132 ± 15 mmHg (T1D target: <130 mmHg), blood triglycerides were 69 mg/dL (T1D norms: 34th percentile), low-density lipoprotein was 129 mg/dL (T1D norms: 60th percentile), heart rate was 56 beats/min (T1D norms: >1SD below the mean), carotid-femoral pulse wave velocity was 7.17 m/s (T1D norms: lowest quartile of risk), flow-mediated dilation was 12.8% (T1D norms: >1SD above mean), and cardiac vagal baroreflex gain was 23.5 ms/mmHg (T1D norms: >1SD above mean). Finally, there was no indication of left ventricular diastolic dysfunction from echocardiography. Overall, these data demonstrate below-average CVD risk relative to T1D norms despite concerns regarding the long-term impact of a KD on CVD risk.NEW & NOTEWORTHY Adults with type 1 diabetes (T1D) have a 10-fold higher risk for cardiovascular disease (CVD) compared with the general population. We assessed cardiovascular health metrics in an adult with T1D who presented with a euglycemic HbA1c after following a ketogenic diet for the past 10 years. Despite concerns about the ketogenic diet increasing CVD risk, the participant exhibited below-average CVD risk relative to others with T1D when considering all outcomes together.

Cerebrovascular adaptations to habitual resistance exercise with aging

Resistance training (RT) is associated with improved metabolism, bone density, muscular strength, and lower risk of osteoporosis, sarcopenia, and cardiovascular disease. Although RT imparts many physiological benefits, cerebrovascular adaptations to chronic RT are not well defined. Participation in RT is associated with greater resting peripheral arterial diameters, improved endothelial function, and general cardiovascular health, whereas simultaneously linked to reductions in central arterial compliance. Rapid blood pressure fluctuations during resistance exercise, combined with reduced arterial compliance, could lead to cerebral microvasculature damage and subsequent cerebral hypoperfusion. Reductions in cerebral blood flow (CBF) accompany normal aging, where chronic reductions in CBF are associated with changes in brain structure and function, and increased risk of neurodegeneration. It remains unclear whether reductions in arterial compliance with RT relate to subclinical cerebrovascular pathology, or if such adaptations require interpretation in the context of RT specifically. The purpose of this narrative review is to synthesize literature pertaining to cerebrovascular adaptations to RT at different stages of the life span. This review also aims to identify gaps in the current understanding of the long-term impacts of RT on cerebral hemodynamics and provide a mechanistic rationale for these adaptations as they relate to aging, cerebral vasculature, and overall brain health.

Effect of an 11-Week Resistance Training Program on Arterial Stiffness in Young Women

ABSTRACT

Morgan, B, Mirza, AM, Gimblet, CJ, Ortlip, AT, Ancalmo, J, Kalita, D, Pellinger, TK, Walter, JM, and Werner, TJ. Effect of an 11-week resistance training program on arterial stiffness in young women. J Strength Cond Res 37(2): 315-321, 2023-The current investigation was conducted to determine the effect of 2 resistance training models on indices of arterial stiffness in young, healthy women. Twenty-four women, untrained college students, aged 18-22 years were randomized into 1 of 3 groups: control (CON) group ( n = 8), high-intensity (HI) resistance exercise group ( n = 8), and high-volume (HV) resistance exercise group ( n = 8). Subjects randomized to resistance training groups were required to perform strength training exercises 3-5 days a week for 11 weeks. The exercise regimen consisted of 2-3 sets of 3-8 repetitions (80-90% of 1 repetition maximum [1RM]) for the HI group and 3-4 sets of 10-15 repetitions (50-70% of 1RM) for the HV group. All subjects were instructed to continue their normal diet and avoid cardiovascular exercise during the study. After the intervention, there was a significant increase in carotid femoral pulse wave velocity (PWV) (6.39 ± 0.73 to 8.40 ± 2.31 m·s -1 ; p < 0.05) and carotid radial PWV (9.77 ± 1.74 to 12.58 ± 2.09 m·s -1 ; p < 0.05) in the CON group alone. Both the HI and HV groups increased their maximum squat (36.6 ± 7.9 vs. 41.3 ± 31.8 percent change; p < 0.05), bench press (34.4 ± 12.6 vs. 23.4 ± 11.1 percent change; p < 0.05), and seated row (22.0 ± 12.6 vs. 21.9 ± 12.5 percent change; p < 0.05), respectively. Our findings support the use of resistance training exercise without undue impact on vascular compliance in otherwise healthy women.

Ankle-Brachial Index and Arterial Stiffness, Modulate the Exertional Capacity of High-Frequency Training Athletes

Ankle-brachial index and arterial stiffness are associated with leg function in the elderly and in patients with peripheral arterial disease. Little is known about the meaning of these parameters in young and trained subjects and how they are related to physical performance. The main objective was to evaluate the mediating role of arterial stiffness and ankle-brachial index in physical performance. In a cross-sectional, case-control study, 240 male athletes were consecutively enrolled from the Laboratory of Cardiology and Sports Medicine, “G. d’Annunzio” University (Italy). All the subjects underwent the examination protocol for the annual medical evaluation for sport participation. Soccer (football) players compared to runners showed a lower level of ankle-brachial index, higher arterial stiffness, and lower systolic and diastolic blood pressure. In the treadmill stress test, soccer players compared to runners showed a greater maximal aerobic capacity. Differences in cardiovascular performance between soccer players and runners were mediated by better arterial stiffness and low level of ankle-brachial index; the estimated effect was 0.11 ± 0.05 and 0.24 ± 0.06, respectively. Vigorous strength training drops blood pressure and increases arterial stiffness. Taken together, our findings would seem to suggest that ABI and CAVI could be used as markers for athletes’ performance.

The Effect of Whole-Body Traditional and Functional Resistance Training on CAVI and Its Association With Muscular Fitness in Untrained Young Men

Background: Resistance training-induced changes in the muscle function is essential for the health promotion of the young and older, but the discrepancies of the effect of resistance training on arterial stiffness leads to the divergence regarding to the effect of resistance training on cardiovascular health. What confuses our understanding in this field may be the following factors: external load (higher intensity vs. lighter intensity), participants’ cardiovascular health, and arterial stiffness assessment measurement. The purpose of the present study was to investigate the effects of the whole-body traditional high-intensity vs. functional low-intensity resistance training protocol on systemic arterial stiffness, and their association with muscular fitness components in untrained young men.

Methods: In this randomized controlled trial, twenty-nine untrained young men (mean age about 22.5 years old) were randomized into a 6-weeks (three sessions per week) supervised whole-body traditional high-intensity resistance group (TRT, n = 15) consisting of 4–5 sets of 12 repetitions (70%1RM, lower-repetitions) or a whole-body functional low-intensity resistance group (FRT, n = 14) with 4–5 sets of 20 repetitions (40%1RM, higher-repetitions) to volitional failure. The systemic arterial stiffness (cardio-ankle vascular index, CAVI) and muscular fitness components were assessed before and after the 6-weeks training program.

Results: There was a significant decrease (pre-post) for CAVI only in FRT group (p < 0.05), but no significant difference was observed between two groups. In addition, the TRT and FRT groups showed equally significantly increased in maximal strength, muscular endurance and power (within group: both p < 0.01); however, the independent t test exhibited that the difference between two groups in terms of change in maximal strength, muscular endurance and power were no significant (p > 0.05). Furthermore, the reduction in CAVI was negatively correlated with the increase in 1RM of bench press for all participants (r = −0.490, p < 0.01).

Conclusion:Using present criterion-standard assessments measurements demonstrates that CAVI was significantly reduced after 6-weeks functional resistance training with beneficial effect on muscular fitness. Negative and significant association between CAVI and 1RM bench press indicated the cardiovascular health may be involved in the regulation of resistance training.

Effects of 6-Week Traditional and Functional Resistance Training on Arterial Stiffness and Muscular Strength in Healthy Young Men

Background

The present study investigated the effects of traditional resistance training (TRT) and functional resistance training (FRT) on arterial stiffness and muscular strength in healthy young men.

Methods

This randomized controlled trial included 29 untrained healthy young men aged 18–29 years who were randomly divided into two groups, namely, TRT group (n = 15) and FRT group (n = 14). All participants underwent numerous tests, such as those for body composition, cardio-ankle vascular index, blood pressure, heart rate, and maximal strength before and after the 6-week training program. The exercise training comprised whole-body strength training exercises 3 days a week for 6 weeks. The total training volume and number of sets (4–5 sets) were kept constantly similar in each group. The TRT group completed 4–5 sets of 8–12 repetitions [70% of 1 repetition maximum (1RM)], whereas the FRT group completed 4–5 sets of 15–22 repetitions (40% 1RM).

Results

The TRT and FRT groups exhibited equally significantly increased maximal strength (within group: both p < 0.01). Furthermore, the independent t-test showed that the differences between the two groups in terms of changes in maximal strength were no significant (between group: both p > 0.05). Additionally, significant main effects of time (pre vs. post) were observed for the left and right cardio-ankle vascular indices (p < 0.05); however, no significant difference were observed between the groups. For body compositions outcome measures, no significant differences between groups were observed.

Conclusion

Six weeks of FRT and TRT exhibit no difference in terms of effects on arterial stiffness and muscular strength.

Low-to-Moderate-Intensity Resistance Exercise Effectively Improves Arterial Stiffness in Adults: Evidence From Systematic Review, Meta-Analysis, and Meta-Regression Analysis

Background/Purpose: Resistance exercise (RE) is known to improve cardiovascular health, but the role of RE variables on arterial stiffness is inconclusive. In this systematic review and meta-analysis, we investigated the influence of RE and its intensities on arterial stiffness measured as pulse wave velocity (PWV) in young and middle-aged adults. Methods: Web of Science, PubMed/MEDLINE, Scopus, EMBASE, Cochrane Library, ScienceDirect, CINAHL, Wiley Online Library, and Google Scholar were searched for relevant studies. RE trials that reported PWV data, and compared with respective controls were included. The Cochrane Collaboration tool was used to assess the risk of bias. Results: Data were synthesized from a total of 20 studies, involving 981 participants from control (n = 462) and exercise (n = 519) trials. The test for overall effect (pooled outcome) showed RE intervention had no effect on arterial stiffness (SMD = -0.09; 95% CI: -0.32, 0.13; P = 0.42), but risk of heterogeneity (I 2) was 64%. Meta-regression results revealed a significant correlation (P = 0.042) between RE intensity and PWV changes. Consequently, the trials were subgrouped into high-intensity and low-to-moderate-intensity to identify the effective RE intensity. Subgroup analysis showed that low-to-moderate-intensity significantly decreased PWV (SMD = -0.34; 95% CI: -0.51, -0.17; P < 0.0001), while high-intensity had no effect (SMD = 0.24; 95% CI: -0.18, 0.67; P = 0.26). When trials separated into young and middle-aged, low-to-moderate-intensity notably decreased PWV in young (SMD = -0.41; 95% CI: -0.77, -0.04; P = 0.03) and middle-aged adults (SMD = -0.32; 95% CI: -0.51, -0.14; P = 0.0007), whereas high-intensity had no effect in both age groups. Conclusions: Our findings demonstrated that RE intensity is the key variable in improving arterial stiffness. Low-to-moderate-intensity can prescribe as an effective non-pharmacological strategy to treat cardiovascular complications in young and middle-aged adults.

Resistance training to reduce resting blood pressure and increase muscle strength in users and non-users of anti-hypertensive medication: A meta-analysis

Objective: The aim of this study was to conduct a systematic review with meta-analysis to analyze the effect of resistance training variables prescription on resting systolic (SBP) and diastolic blood pressure (DBP) and muscle strength changes. Methods: The search was conducted in the PubMed, Web of Science, and SPORTDiscus databases until August 2020 for randomized controlled trials with non-exercising control group. Results: In total, 36 studies qualified for inclusion in this meta-analysis. Eleven studies included users of antihypertensive medication, while the remaining 25 studies were conducted with non-users of antihypertensive medication. Resistance training only reduced SBP (-0.56 [-0.77 to -0.35]; P < .001) and DBP (-0.46 [-0.68 to -0.24]; P < .001) in anti-hypertensive medication users, with changes ranging from -6.1 to -2.8 mmHg for SBP and -4.6 to -1.6 mmHg for DBP. Muscle strength increased significantly in both users (0.76 [0.49 to 1.02]; P < .001) and non-users of antihypertensive medication (0.94 [0.71 to 1.16]; P < .001). Resistance training should be performed by users and non-users of antihypertensive medication for 8 to 16 weeks (2 to 3 days a week) and 8 to 12 non-failure repetitions. However, users should train with less load (60-80 vs 70-85% 1RM) and exercise sets (1-3 vs 2-4) than non-users of antihypertensive medication. Conclusion: Resistance training increases muscle strength and reduces resting SBP and DBP in individuals under BP pharmacological therapy, while in individuals who do not use antihypertensive drugs, resistance training only increases strength.

Habitual Combined Exercise Protects against Age-Associated Decline in Vascular Function and Lipid Profiles in Elderly Postmenopausal Women

Postmenopausal status is associated with increased risks for cardiovascular diseases (CVD). This study investigated differences in vascular function, lipids, body composition, and physical fitness in elderly postmenopausal women active in combined resistance and aerobic exercise (CRAE) training for 1 year versus a sedentary cohort of similar-in-age counterparts. Elderly postmenopausal women performing habitual CRAE training for 1 year (age ~75 year; CRAE, n = 57) and elderly sedentary postmenopausal women (age ~78 year; SED, n = 44) were recruited. Arterial stiffness (brachial-to-ankle pulse-wave velocity, baPWV), blood pressure, blood lipids, anthropometrics, 2-min walking distance, and muscular strength were assessed for both groups. There were significant differences for baPWV, systolic blood pressure, low-density lipoprotein, and body fat percentage, which were significantly lower (p < 0.05) in CRAE vs. SED, and both 2 min walking distance and muscular strength were significantly greater (p < 0.05) in CRAE vs. SED. These results indicate that elderly postmenopausal women participating in habitual CRAE training may have better protection against risks for CVD and have better physical fitness compared to SED counterparts.