Key result
Exercise training reduces carotid-femoral pulse wave velocity by ~0.7 m/s versus control.
Why the study?
To compare the effects of different exercise modalities and exercise doses on carotid-femoral pulse wave velocity in adults.
Does exercise training reduce carotid-femoral pulse wave velocity in adults?
Meta-Analysis (n=3,422)
Does exercise training reduce carotid-femoral pulse wave velocity in adults?
Mean Difference: -0.74 (95% CI -1.02–-0.46)
Exercise training, particularly combined, aerobic, and interval training, is associated with significant reductions in carotid-femoral pulse wave velocity, a key surrogate marker of arterial stiffness.
Supports prescribing combined exercise to reduce arterial stiffness; reinforces meta-analytic evidence for vascular benefits in adults.
Purpose To compare the effects of exercise modalities and exercise dose on carotid-femoral pulse wave velocity (cfPWV) in adults using pairwise meta-analysis, network meta-analysis, and dose-response analysis. Methods PubMed/MEDLINE, Cochrane Library, Web of Science, EBSCO, Embase, and Scopus were searched from inception to 28 January 2026 for parallel-group randomized controlled trials in adults reporting cfPWV. Trials evaluating seven exercise modalities were included. Pairwise meta-analysis, frequentist network meta-analysis, and Bayesian dose-response analysis were performed. Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool, and certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Results Sixty-nine studies involving 3,422 participants were included. Overall, exercise reduced cfPWV vs. control (WMD = −0.74 m/s, 95% CI −1.02 to −0.46), although heterogeneity was considerable. In the network meta-analysis, aerobic training, combined training, and interval training reduced cfPWV vs. non-exercise control, but no active modality was statistically superior to another. Certainty of evidence was moderate for combined training, low for aerobic training, and very low for interval training vs. control. Bayesian dose-response modelling suggested a nonlinear, model-derived association, with greater uncertainty at the extremes of the dose distribution. Conclusion Exercise training was associated with lower cfPWV in adults, with the most consistent certainty supporting combined training. Comparative rankings and dose-response estimates should be interpreted as exploratory because of heterogeneity, initial network inconsistency, prediction intervals crossing the null, and model-dependent dose estimation. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420261355633 , PROSPERO identifier CRD420261355633.
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Tan et al. (2026) conducted a meta-analysis in Arterial stiffness (n=3,422). Exercise training vs. Non-exercise control was evaluated on Carotid-femoral pulse wave velocity (cfPWV) (WMD -0.74, 95% CI -1.02 to -0.46). Exercise training significantly reduced carotid-femoral pulse wave velocity compared to non-exercise control (WMD -0.74 m/s), with combined training showing the most consistent certainty of evidence.
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