The effect of endurance (low intensity) training on managing the risk and progression of CVD in middle-aged adults: a systematic review

Background Cardiovascular disease (CVD) is the leading cause of death in middle-aged adults worldwide. Much of the evidence base surrounds high-intensity training and often fails to recognise the difficulty in long-term sustainability and the associated health risks. Endurance training is known for improving cardiac function post-significant cardiac events, but little evidence is available around whether it is effective in managing the progression of CVD. The aim is to determine whether endurance training is effective in improving cardiometabolic biomarkers in middle-aged adults with identified cardiac risk factors.Methods A systematic search was carried out via three electronic databases. 3988 articles were identified. 24 full texts were assessed for eligibility. Six were included for data and narrative synthesis. Data were extracted and appraised before a secondary analysis assessing the risk of bias was conducted.Results Data were obtained from 308 individuals for V̇O2 max, HDL, LDL and CRP. Endurance training was shown to significantly increase V̇O2 max, significantly reduce LDL and CRP and produce inconsistent changes to HDL.Conclusion Endurance training can elicit positive improvements in V̇O2 max, LDL and CRP in middle-aged adults with moderate CVD and associated risk factors. Longitudinal studies are required to compare the long-term endurance training effect on this population.