scholarly journals Effects of Aerobic, Resistance and Combined Training on Endothelial Function and Arterial Stiffness in Older Adults: Study Protocol for a Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Raphael Silveira Nunes da Silva ◽  
Diego Silva ◽  
Gustavo Waclawovski ◽  
Maximiliano Isoppo Silva
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Arterial Stiffness ◽  
Endothelial Function ◽  
Study Protocol ◽  
Vascular Function ◽  
Cardiovascular Events ◽  
Meta Analysis ◽  
Control Group ◽  
Combined Training

Abstract Introduction: Aging is an independent risk factor for cardiovascular events. It promotes vascular dysfunction which is associated with risk factors for cardiovascular diseases (CVDs). Exercise can modulate vascular function parameters, but little is known about the effects of different modalities of training (aerobic, resistance and combined) on endothelial function and arterial stiffness in older adults. Methods: This systematic review study will include randomized controlled trials (RCTs) selected from the electronic databases MEDLINE (PubMed), Cochrane, LILACS, EMBASE and Web of Science. We will follow the PRISMA guidelines and PICOS framework. Studies involving both male and female older adults (≥60 years old) with or without comorbidities undergoing aerobic, resistance and/or combined training compared to a control group (no exercise) will be eligible. We will use Cochrane Risk of Bias 2 (RoB 2) tool to evaluate the quality of individual studies and GRADE to assess the strength of evidence. Statistical analyses will be conducted with RStudio for Windows (v1.3.959) using R package meta. Discussion: A systematic review and meta-analysis involving data from studies of older adults would deepen our understanding of vascular adaptations to exercise training in this population. It could provide new insights into how health providers can improve patient management and prevention of cardiovascular events in older adults. Systematic Review Registry: The study protocol for this review is awaiting approval for registration in the International Prospective Register of Systematic Reviews (PROSPERO) (ID 42021275451).

scholarly journals Dose-Response Relationship between Endurance Training Prescription Variables and Increases in Aerobic Performance of Healthy and Unhealthy Middle and Very Old Individuals Aged 70 Years and Older: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Life ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 121
Author(s):  
Sarah Cheour ◽  
Chouaib Cheour ◽  
Nicola Luigi Bragazzi ◽  
Liye Zou ◽  
Armin H. Paravlic ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Endurance Training ◽  
Dose Response ◽  
Meta Analysis ◽  
Aerobic Performance ◽  
Control Group ◽  
Very Old ◽  
Randomized Controlled ◽  
Randomized Controlled Studies

Background: The objectives of this systematic review and meta-analysis were to quantify the effectiveness of endurance training (ET) on aerobic performance (i.e., peak oxygen uptake (VO2peak)) in healthy and unhealthy middle and very old adults aged 70 years and older, and to provide dose–response relationships of training prescription variables (in terms of frequency, and volume). Methods: Several scholarly databases (i.e., PubMed/MEDLINE, SpringerLink, ScienceDirect Journals, and Taylor & Francis Online—Journals) were searched, identifying randomized controlled studies that investigated the effectiveness of ET on VO2peak in older adults. Standardized mean differences (SMD) were calculated. Results: In terms of changes differences between experimental and control group, ET produced significant large effects on VO2peak performance (SMD = 2.64 (95%CI 0.97–4.31)). The moderator analysis revealed that “health status” variable moderated ET effect onVO2peak performance. More specifically, ET produced larger SMD magnitudes on VO2peak performance in healthy compared with unhealthy individuals. With regard to the dose–response relationships, findings from the meta-regression showed that none of the included training prescription variables predicted ET effects on VO2peak performance. Conclusions: ET is an effective mean for improving aerobic performance in healthy older adults when compared with their unhealthy counterparts.

scholarly journals Febuxostat and Cardiovascular Events: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
John A. Cuenca ◽  
Javier Balda ◽  
Ana Palacio ◽  
Larry Young ◽  
Michael H. Pillinger ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Cardiovascular Events ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
The United States ◽  
Major Adverse Cardiovascular Events ◽  
Control Group ◽  
Embase Database ◽  
Cvd Mortality

Background. Febuxostat is approved in the United States for the management of hyperuricemia in patients with gout. In November 2017 the FDA released a warning alert on a possible link between febuxostat and cardiovascular disease (CVD) reported in a single clinical trial. Objective. To conduct a systematic review and meta-analysis and assess the risk of major adverse cardiovascular events (MACE) in patients receiving febuxostat compared to a control group. Methods. We searched the MEDLINE and EMBASE database for studies published up until March 2018. We included randomized clinical trials (RCTs) that compared febuxostat to control groups including placebo and allopurinol. We calculated the pooled relative risk (RR) of MACE and cardiovascular disease (CVD) mortality with the corresponding 95% confidence intervals (CI). Results. Our search yielded 374 potentially relevant studies. Among the 25 RCTs included in the systematic review, 10 qualified for the meta-analysis. Among the 14,402 subjects included, the median age was 54 years (IQR 52-67) and 90% were male (IQR 82-96); 8602 received febuxostat, 5118 allopurinol, and 643 placebo. The pooled RR of MACE for febuxostat was 0.9; 95% CI 0.6-1.5 (p= 0.96) compared to the control. The RR of CV-related death for febuxostat was 1.29; 95% CI 1.01-1.66 (p=0.03). Conclusions. Compared with other SU-lowering treatments, febuxostat does not increase or decrease the risk of cardiovascular disease but may increase the risk of CVD death. More RCTs measuring cardiovascular safety as a primary outcome are needed to adequately evaluate the risk of CVD with febuxostat.

scholarly journals Mediterranean Diet Increases Endothelial Function in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 150 (5) ◽  
pp. 1151-1159 ◽  
Author(s):  
Oliver M Shannon ◽  
Inês Mendes ◽  
Christina Köchl ◽  
Mohsen Mazidi ◽  
Ammar W Ashor ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Status ◽  
Endothelial Function ◽  
Randomized Controlled Trials ◽  
Study Design ◽  
Meta Analysis ◽  
Control Group ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Study Duration

ABSTRACT Background The endothelium plays a key role in the maintenance of vascular health and represents a potential physiological target for dietary and other lifestyle interventions designed to reduce the risk of cardiovascular diseases (CVD) including stroke or coronary heart disease. Objective To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating the effects of the Mediterranean dietary pattern (MedDiet) on endothelial function. Methods Medline, Embase, and Scopus databases were searched from inception until January 2019 for studies that met the following criteria: 1) RCTs including adult participants, 2) interventions promoting the MedDiet, 3) inclusion of a control group, and 4) measurements of endothelial function. A random-effects meta-analysis was conducted. Metaregression and subgroup analyses were performed to identify whether effects were modified by health status (i.e., healthy participants versus participants with existing comorbidities), type of intervention (i.e., MedDiet alone or with a cointervention), study duration, study design (i.e., parallel or crossover), BMI, and age of participants. Results Fourteen articles reporting data for 1930 participants were included in the meta-analysis. Study duration ranged from 4 wk to 2.3 y. We observed a beneficial effect of the MedDiet on endothelial function [standardized mean difference (SMD): 0.35; 95% CI: 0.17, 0.53; P <0.001; I2 = 73.68%]. MedDiet interventions improved flow-mediated dilation (FMD)—the reference method for noninvasive, clinical measurement of endothelial function—by 1.66% (absolute change; 95% CI: 1.15, 2.17; P <0.001; I2 = 0%). Effects of the MedDiet on endothelial function were not modified by health status, type of intervention, study duration, study design, BMI, or age of participants (P >0.05). Conclusions MedDiet interventions improve endothelial function in adults, suggesting that the protective effects of the MedDiet are evident at early stages of the atherosclerotic process with important implications for the early prevention of CVD. This study has the PROSPERO registration number: CRD42018106188.

scholarly journals The Efficacy of Stretching Exercises on Arterial Stiffness in Middle-Aged and Older Adults: A Meta-Analysis of Randomized and Non-Randomized Controlled Trials

2020 ◽  
Vol 17 (16) ◽  
pp. 5643 ◽  
Author(s):  
Michitaka Kato ◽  
Fumi Nihei Green ◽  
Kazuki Hotta ◽  
Toshiya Tsukamoto ◽  
Yasunari Kurita ◽  
...  
Keyword(s):  
Older Adults ◽  
Arterial Stiffness ◽  
Endothelial Function ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Vascular Endothelial ◽  
Vascular Endothelial Function ◽  
Middle Aged ◽  
Randomized Controlled ◽  
Stretching Exercises

Background: Aerobic exercise is known to reduce arterial stiffness; however, high-intensity resistance exercise is associated with increased arterial stiffness. Stretching exercises are another exercise modality, and their effect on arterial stiffness remains unclear. The purpose of this study was to determine whether stretching exercises reduce arterial stiffness in middle-aged and older adults, performing the first meta-analysis of currently available studies. Methods: We searched the literature for randomized controlled trials (RCTs) and non-RCTs published up to January 2020 describing middle-aged and older adults who participated in a stretching intervention vs. controls without exercise training. The primary and secondary outcomes were changes in arterial stiffness and vascular endothelial function and hemodynamic status. Pooled mean differences (MDs) and standard MDs (SMDs) with 95% confidence intervals (CIs) between the intervention and control groups were calculated using a random effects model. Results: We identified 69 trials and, after an assessment of relevance, eight trials, including a combined total of 213 subjects, were analyzed. Muscle stretching exercises were shown to significantly reduce arterial stiffness and improve vascular endothelial function (SMD: −1.00, 95% CI: −1.57 to −0.44, p = 0.0004; SMD: 1.15, 95% CI: 0.26 to 2.03, p = 0.01, respectively). Resting heart rate (HR) and diastolic blood pressure (DBP) decreased significantly after stretching exercise intervention (MD: −0.95 beats/min, 95% CI: −1.67 to −0.23 beats/min, p = 0.009; MD: −2.72 mm Hg, 95% CI: −4.01 to −1.43 mm Hg, p < 0.0001, respectively) Conclusions: Our analyses suggest that stretching exercises reduce arterial stiffness, HR, and DBP, and improve vascular endothelial function in middle-aged and older adults.

scholarly journals Longer-Term Soy Nut Consumption Improves Vascular Function and Cardiometabolic Risk Markers in Older Adults: Results of a Randomized, Controlled Cross-Over Trial

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 58-58
Author(s):  
Lea Tischmann ◽  
Tanja Adam ◽  
Ronald Mensink ◽  
Peter Joris
Keyword(s):  
Older Adults ◽  
Arterial Stiffness ◽  
Endothelial Function ◽  
Vascular Function ◽  
Ldl Cholesterol ◽  
Control Period ◽  
Daily Intake ◽  
Cardiometabolic Health ◽  
Cvd Risk ◽  
Randomized Controlled

Abstract Objectives Soy foods may contribute to the beneficial effects of plant-based diets on cardiovascular disease (CVD) risk. However, their effects on vascular function have hardly been investigated. The objective was to investigate if longer-term soy nut consumption improves vascular function and cardiometabolic health in older adults. Methods Twenty-three apparently healthy participants (60–70 years; BMI between 20–30 kg/m2) participated in a randomized, controlled, single-blinded cross-over trial with an intervention (67 g of soy nuts daily providing 25.5 g soy protein) and control period (no nuts) of 16 weeks, separated by eight weeks wash-out. Volunteers followed the Dutch food-based dietary guidelines. At baseline and at 8 and 16 weeks anthropometric measurements and fasting blood samples were collected. Markers of vascular function (i.e., endothelial function, arterial stiffness, and microvascular structure) were assessed at week 16. Results No serious adverse events were reported and the soy nut regime was well tolerated. Body weight remained stable. Serum isoflavone concentrations, a marker of compliance, increased after the intervention period (daidzein: 128.3 ng/mL; 95% CI: 72.6–183.9 ng/mL; P &lt; 0.001 and genistein: 439.8 ng/mL 95% CI: 246.7–632.9 ng/mL; P &lt; 0.001). The brachial artery flow-mediated vasodilation (FMD) response increased by 1.49 pp (95% CI: 0.03–2.95 pp; P = 0.046) following the soy intervention, but no effect was found on the carotid artery reactivity (CAR) response. Arterial stiffness, assessed by carotid-to-femoral pulse wave velocity (PWVc-f), was unchanged. Retinal arteriolar calibers (CRAE), a measure for microvascular structure, tended to improve by 1.42 mm (95% CI: −0.05–2.90 mm; P = 0.059). Soy consumption also lowered serum LDL-cholesterol concentrations by 0.17 mmol/L (95% CI: 0.02–0.32 mmol/L; P = 0.027). HDL-cholesterol and triacylglycerol (TAG) did not change. Finally, office SBP and DBP decreased by 4 mmHg (95% CI: 0–8 mmHg; P = 0.034) and 2 mmHg (95% CI: 1–4 mmHg; P = 0.005), respectively. Conclusions A longer-term daily intake of soy nuts improved endothelial function, office blood pressure, and serum LDL-cholesterol concentrations, suggesting mechanisms by which an increased soy food intake beneficially affects CVD risk in older adults. Funding Sources This study was supported by a grant from the Alpro Foundation.

Impact of the menstrual cycle on peripheral vascular function in premenopausal women: systematic review and meta-analysis

2020 ◽  
Vol 319 (6) ◽  
pp. H1327-H1337
Author(s):  
Jennifer S. Williams ◽  
Emily C. Dunford ◽  
Maureen J. MacDonald
Keyword(s):  
Systematic Review ◽  
Menstrual Cycle ◽  
Endothelial Function ◽  
Vascular Function ◽  
Meta Analysis ◽  
Premenopausal Women ◽  
Cycle Phase ◽  
Peripheral Vascular ◽  
The Impact

Fluctuations in endogenous hormones estrogen and progesterone during the menstrual cycle may offer vasoprotection for endothelial and smooth muscle (VSM) function. While numerous studies have been published, the results are conflicting, leaving our understanding of the impact of the menstrual cycle on vascular function unclear. The purpose of this systematic review and meta-analysis was to consolidate available research exploring the role of the menstrual cycle on peripheral vascular function. A systematic search of MEDLINE, Web of Science, and EMBASE was performed for articles evaluating peripheral endothelial and VSM function across the natural menstrual cycle: early follicular (EF) phase versus late follicular (LF), early luteal, mid luteal, or late luteal. A meta-analysis examined the effect of the menstrual cycle on the standardized mean difference (SMD) of the outcome measures. Analysis from 30 studies ( n = 1,363 women) observed a “very low” certainty of evidence that endothelial function increased in the LF phase (SMD: 0.45, P = 0.0001), with differences observed in the macrovasculature but not in the microvasculature (SMD: 0.57, P = 0.0003, I2 = 84%; SMD: 0.21, P = 0.17, I2 = 34%, respectively). However, these results are partially explained by differences in flow-mediated dilation [e.g., discrete (SMD: 0.86, P = 0.001) vs. continuous peak diameter assessment (SMD: 0.25, P = 0.30)] and/or menstrual cycle phase methodologies. There was a “very low” certainty that endothelial function was largely unchanged in the luteal phases, and VSM was unchanged across the cycle. The menstrual cycle appears to have a small effect on macrovascular endothelial function but not on microvascular or VSM function; however, these results can be partially attributed to methodological differences.

scholarly journals Effects of exercise training with blood flow restriction on vascular function in adults: a systematic review and meta-analysis

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e11554
Author(s):  
Elisio A. Pereira-Neto ◽  
Hayley Lewthwaite ◽  
Terry Boyle ◽  
Kylie Johnston ◽  
Hunter Bennett ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Flow ◽  
Adverse Events ◽  
Endothelial Function ◽  
Vascular Function ◽  
Chronic Conditions ◽  
Meta Analysis ◽  
Blood Flow Restriction ◽  
Flow Restriction ◽  
Meta Regression

Background Blood flow restricted exercise (BFRE) improves physical fitness, with theorized positive effects on vascular function. This systematic review and meta-analysis aimed to report (1) the effects of BFRE on vascular function in adults with or without chronic health conditions, and (2) adverse events and adherence reported for BFRE. Methodology Five electronic databases were searched by two researchers independently to identify studies reporting vascular outcomes following BFRE in adults with and without chronic conditions. When sufficient data were provided, meta-analysis and exploratory meta-regression were performed. Results Twenty-six studies were included in the review (total participants n = 472; n = 41 older adults with chronic conditions). Meta-analysis (k = 9 studies) indicated that compared to exercise without blood flow restriction, resistance training with blood flow restriction resulted in significantly greater effects on endothelial function (SMD 0.76; 95% CI [0.36–1.14]). No significant differences were estimated for changes in vascular structure (SMD −0.24; 95% CI [−1.08 to 0.59]). In exploratory meta-regression analyses, several experimental protocol factors (design, exercise modality, exercised limbs, intervention length and number of sets per exercise) were significantly associated with the effect size for endothelial function outcomes. Adverse events in BFRE studies were rarely reported. Conclusion There is limited evidence, predominantly available in healthy young adults, on the effect of BFRE on vascular function. Signals pointing to effect of specific dynamic resistance exercise protocols with blood flow restriction (≥4 weeks with exercises for the upper and lower limbs) on endothelial function warrant further investigation.

scholarly journals Effect of Tai Chi on Cognitive Function among Older Adults with Cognitive Impairment: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Renjun Gu ◽  
Yujia Gao ◽  
Chunbing Zhang ◽  
Xiaojuan Liu ◽  
Zhiguang Sun
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Tai Chi ◽  
Digit Span ◽  
Meta Analysis ◽  
Control Group ◽  
Clinical Dementia Rating

Background. Cognitive decline occurs in all persons during the aging process and drugs can only alleviate symptoms and are expensive. Some researches demonstrated that Tai Chi had potential in preventing cognitive decline while others’ results showed Tai Chi had no influence on cognitive impairment. Therefore, we conduct a systematic review and meta-analysis to assess the efficacy and safety of cognitive impairment patients practicing Tai Chi. Methods. A comprehensive literature search was carried out in multiple databases, including PubMed, Cochrane, MEDLINE (Ovid), Web of Science, Embase, Scopus, PsycInfo (Ovid), CKNI, Wan Fang, VIP, SinoMed, and ClinicalTrails, from their inception to 1 July 2020 to collect randomized controlled trials about practicing Tai Chi for patients with cognitive impairment. Primary outcomes included changes of cognitive function and secondary outcomes included changes of memory functions. Data were extracted by two independent individuals and Cochrane Risk of Bias tool version 2.0 was applied for the included studies. Systematic review and meta-analysis were performed by RevMan 5.3 software. Results. The results included 827 cases in 9 studies, of which 375 were in the experimental group and 452 were in the control group. Meta-analysis showed that Mini-Mental State Examination WMD = 1.52, 95% CI [0.90, 2.14]; Montreal Cognitive Assessment WMD = 3.5, 95% CI [0.76, 6.24]; Clinical Dementia Rating WMD = −0.55, 95% CI [−0.80, −0.29]; logical memory delayed recall WMD = 1.1, 95% CI [0.04, 2.16]; digit span forward WMD = 0.53, 95% CI [−0.65, 1.71]; and digit span backward WMD = −0.1, 95% CI [−0.38, 0.19]. No adverse events were reported in the included articles. Conclusion. There is limited evidence to support that practicing Tai Chi is effective for older adults with cognitive impairment. Tai Chi seems to be a safe exercise, which can bring better changes in cognitive function score.

Role of whey protein in vascular function: a systematic review and meta-analysis of human intervention studies

2021 ◽  
pp. 1-34
Author(s):  
Fatemeh Hajizadeh-Sharafabad ◽  
Elham Sharifi Zahabi ◽  
Ali Tarighat-Esfanjani
Keyword(s):  
Systematic Review ◽  
Arterial Stiffness ◽  
Whey Protein ◽  
Vascular Function ◽  
English Language ◽  
Vascular Reactivity ◽  
Augmentation Index ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Effect Sizes

Abstract Whey protein (WP) has been heavily appreciated as a rich source of bioactive peptides, with potential benefits for cardiovascular health. This study constitutes a systematic review and meta-analysis summarizing the effects of WP consumption on vascular reactivity, arterial stiffness, and circulatory biomarkers of vascular function. We searched electronic databases, including PubMed, SCOPUS, and Web of science for relevant articles from inception to July 2020. Original clinical trials published in English-language journals that investigated the effects of WP on vascular function were eligible. A total of 720 records were identified in the initial search; from these, 16 were included in our systematic review and 13 in meta-analysis. The pooled analysis of 6 studies showed a significant increase in flow-mediated dilation (FMD) after WP consumption (WMD: 1.09%, 95% CI: 0.17, 2.01, P=0.01). Meta-analysis of available data didn’t show any significant reduction in arterial stiffness measures including augmentation index (effect sizes: 7, WMD: −0.29%, 95% CI: −1.58, 0.98, P=0.64) and pulse wave velocity (effect sizes: 4, WMD: −0.72 m/s, 95% CI: −1.47, 0.03, P=0.06). Moreover, the pooled analysis of 6 effect sizes showed no significant effects on plasma levels of nitric oxide following WP supplementation (WMD: 0.42 μmol/L, 95% CI: −0.52 to 1.36, P=0.38). The overall results provided evidence supporting a protective effect of WP on endothelial function measured by FMD, but not for arterial stiffness measures and circulatory biomarker of vascular function. Further research is required to substantiate the benefits of WP on vascular function.

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