What is the clinical evidence from this study?

Study design: Systematic Review. Population: Arterial stiffness (n=1102). Intervention: Concurrent aerobic and resistance training vs. Resistance training, aerobic training, or no exercise. Primary outcome: Change in arterial stiffness measured by pulse wave velocity (PWV) (MD -0.85 m/s).

What does this research mean for the field?

Combined aerobic and resistance training is the most effective exercise strategy for reducing arterial stiffness in older adults, providing greater benefits than aerobic or resistance training alone. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

January 15, 2026Open Access

Arterial stiffness adaptations to chronic resistance and aerobic exercise: a systematic review of exercise modalities

ISIna ShawUniversity of Essex MMMusa Lewis MathunjwaUniversity of Zululand JBJane M. BlackUniversity of Suffolk

Key Result

Concurrent aerobic and resistance training consistently reduced arterial stiffness in older adults (MD -0.85 m/s), proving more effective than aerobic training alone or resistance training.

Study Design

Type

Systematic Review (n=1,102)

Structured PICO

Does chronic structured exercise (resistance, aerobic, or concurrent training) reduce arterial stiffness in older adults aged 60 years and above?

Population

1,102 older adults aged 60 years and older across 16 randomized controlled trials evaluating the effects of at least 8 weeks of resistance, aerobic, or concurrent training on arterial stiffness.

Intervention

Chronic (≥ 8 weeks) structured exercise intervention consisting of resistance training (RT), aerobic training (AER), or concurrent aerobic plus resistance training (CON)

Outcome

Arterial stiffness assessed using pulse wave velocity (PWV)surrogate

Combined aerobic and resistance training is the most effective non-pharmacological exercise strategy for reducing arterial stiffness in older adults.

Main Result

Mean Difference: -0.85

Limitations

Wide variation (heterogeneity) in study designs, participant populations, exercise protocols, and arterial stiffness outcome measures
Predominantly male and of Caucasian origin in some cohorts
Insufficiently described intervention details in some primary studies
Restricting the review to English-language studies may have introduced language bias
Potential for residual publication bias

Abstract

Background: Arterial stiffness is a strong predictor of cardiovascular morbidity and mortality, especially in older adults. Despite exercise being shown to positively influence arterial health, the relative effectiveness of various exercise modalities remains unclear. Objectives: This systematic review aimed to examine the effects of resistance training (RT), aerobic training (AER), and concurrent aerobic plus resistance training (CON) on arterial stiffness in older adults, a recognised modifiable and independent cardiovascular risk factor. Methods: A comprehensive search of Medline (EBSCO), EMBASE, the Cochrane Database of Systematic Reviews, and clinicaltrials.gov was conducted. The robust search strategy, which also included systematic reviews being hand-searched for relevant articles and a forward and backwards citation search on the included articles, was employed to reduce the risk of selection and publication biases. Studies included in the review assessed arterial stiffness using pulse wave velocity (PWV) and focused on individuals aged 60 years and above who participated in a chronic (≥ 8 weeks) structured exercise intervention (RT, AER, or CON). Only randomised controlled trials were included. Sixteen studies met the inclusion criteria, and their methodological quality was evaluated using the PEDro scale. Results: The findings indicated that resistance training generally had a neutral effect (mean difference, MD: 0.06 m/s. SD: ±0.45) on arterial stiffness, whilst aerobic training produced modest improvements (MD: -0.62 m/s, SD: ±0.51). Notably, concurrent training consistently reduced arterial stiffness across diverse older adult(s) populations (MD: -0.85 m/s, SD: ±0.63). Conclusion: Combined aerobic and resistance training is the most effective non-pharmacological strategy for reducing arterial stiffness in older adults. This approach may offer essential benefits for cardiovascular health and healthy ageing. Further long-term studies are needed to explore the mechanisms involved and to inform tailored exercise interventions in geriatric populations.

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