Cardiovascular adaptation to whole-body vibration exercise in obese young adults: A systematic review, meta-analysis, and exploratory analysis of sex differences

Background: Obesity is strongly associated with hypertension and autonomic dysfunction. Whole-body vibration exercise (WBVE) has been proposed as a low-impact intervention for improving cardiovascular function in obese adults, but sex-specific responses remain unclear. Objective: This study aimed to evaluate the effects of whole-body vibration exercise on blood pressure, autonomic function, and cardiac output in adults with obesity, and to explore potential sex differences in cardiovascular adaptations. Methods: We conducted a systematic review and meta-analysis of randomized controlled trials and quasi-experimental studies examining the effects of WBV on systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate variability (HRV), and cardiac output (CO) in adults with obesity. Electronic searches were conducted in PubMed, Scopus, Web of Science, Cochrane CENTRAL, Embase, CINAHL, and PEDro through June 2025 and updated on October 19, 2025. Two reviewers independently screened studies, extracted data, and assessed risk of bias. Blood pressure outcomes were measured with study-reported clinical devices, while HRV outcomes were obtained from ECG-based or validated HRV monitoring systems where reported. A random-effects meta-analysis was conducted; standardized mean differences (SMDs) with 95% confidence intervals (CIs) are reported. Heterogeneity was quantified using I². Result: Ten studies (n = 1,106 participants) met inclusion criteria. Pooled analysis indicated a moderate reduction in SBP following WBVE (SMD = –0.42; 95% CI, –0.65 to –0.19; I² = 45%). DBP showed a small-to-moderate reduction. Improvements in HRV, including greater HF power and reduced LF/HF ratio, were reported across five studies, suggesting increased parasympathetic modulation. Only two studies measured CO, finding transient acute increases. Female-only studies reported more consistent improvements than mixed-sex cohorts, but male-only data were sparse, preventing firm conclusions. Conclusion: Whole-body vibration exercise may modestly improve blood pressure and autonomic function in adults with obesity, although evidence regarding sex differences remains limited and inconclusive.