Key result
HIIT+RT strongly reduces arterial stiffness vs control and ranks highest in efficacy.
Why the study?
Arterial stiffness is elevated in individuals with overweight or obesity, but the comparative efficacy and optimal dose across different exercise modalities remain unclear.
Do different exercise modalities and doses reduce arterial stiffness in individuals with overweight and obesity?
Meta-Analysis (n=2,064)
Do different exercise modalities and doses reduce arterial stiffness in individuals with overweight and obesity?
Effect estimate: SMD -0.95 (95% CI -1.58 to -0.33)
p-value: p=<0.01
Exercise, particularly HIIT and aerobic exercise, significantly improves arterial stiffness in overweight and obese individuals, with modality-specific dose-response plateaus.
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Supports prescribing HIIT or aerobic exercise to lower arterial stiffness in overweight and obese adults; extends modality-specific dose-response evidence for vascular outcomes.
Objective Arterial stiffness (AS), an independent cardiovascular risk factor, is elevated in individuals with overweight or obesity. Exercise is a key non-pharmacological intervention, yet the comparative efficacy and optimal dose across modalities remain unclear. This study aimed to evaluate the effects of different exercise types and doses on AS in overweight and obese populations. Methods A systematic search of PubMed, Web of Science, EBSCO, Cochrane Library, and Embase identified randomized controlled trials (RCTs) published up to August 2025. Bayesian network meta-analysis and dose–response analysis were conducted using Stata 17.0 and R software. Results 40 RCTs (n = 2,064) were included, covering five exercise modalities: aerobic exercise (AE), resistance training (RT), combined AE and RT (CT), high-intensity interval training (HIIT), and HIIT + RT. Compared with controls, AE (SMD = − 0.81), RT (–0.48), HIIT (–0.87), and HIIT + RT (–0.95) significantly reduced arterial stiffness, whereas CT showed a borderline reduction (SMD = − 0.39, 95% CI: − 0.79 to 0.00). HIIT + RT ranked highest in efficacy, followed by HIIT, AE, and RT, with CT ranked lowest. Bayesian dose–response analysis demonstrated a nonlinear L-shaped association, with a minimum effective dose of 92 MET-min/week and the overall benefit approaching a plateau at approximately 670 MET-min/week. Modality-specific plateau ranges were approximately 720 MET-min/week for AE, 390 MET-min/week for HIIT, and 550 MET-min/week for HIIT + RT. No significant dose–response relationship was identified for RT or CT. Conclusions Exercise improves arterial stiffness in individuals with overweight or obesity. AE, HIIT, and HIIT + RT showed favorable effects, although the apparent superiority of HIIT + RT should be interpreted cautiously because the available evidence remains limited. The findings support the use of modality-specific dose ranges, rather than a single overall dose estimate, to inform individualized exercise prescription. Further large-scale direct randomized controlled trials are needed to confirm these findings.
Di et al. (2026) conducted a meta-analysis in Overweight and obesity (n=2,064). Exercise (HIIT+RT, HIIT, AE, RT) vs. No exercise control was evaluated on Arterial stiffness (SMD -0.95, 95% CI -1.58 to -0.33, p=<0.01). High-intensity interval training combined with resistance training (HIIT+RT) significantly reduced arterial stiffness compared to control (SMD -0.95) and ranked highest in efficacy.
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