Supervised aquatic-based exercise for men with coronary artery disease: a meta-analysis of randomised controlled trials

The beneficial effect of conventional forms of exercise for people with coronary artery disease (CAD) has been widely investigated.1 Recent studies showed that less established fitness activities can also lead to health benefits.2 Among these, aquatic-based exercise (AqEx) was shown to improve cardiovascular fitness, risk profile and muscle strength in healthy and special populations.3,–5 The intrinsic properties of water have been responsible for the observed physiological effects following acute and long-term exercise interventions. During immersion at the neck level, hydrostatic pressure redirects approximately 700 ml of peripheral blood centrally, increasing cardiac preload and stroke volume.6 Recent reviews confirmed that the haemodynamic changes of AqEx are also well tolerated in stable patients with heart failure (HF), provided...