Effects of a 4-Week Pilates Program on Cardiovascular, Metabolic, and Neuroendocrine Responses in Previously Sedentary Adult Women: An Age-Stratified Longitudinal Study

Background: Mind–body exercise interventions such as Pilates have been increasingly investigated for their potential to improve cardiovascular, metabolic, and neuroendocrine regulation; however, age-related physiological adaptations in previously sedentary women remain insufficiently characterized. Objective: To evaluate cardiovascular, metabolic, and neuroendocrine responses to a 4-week Pilates intervention in previously sedentary adult women using a single-arm longitudinal study design. Methods: This prospective longitudinal study included 30 women stratified into two age groups: 30–40 years (n = 15) and 50–60 years (n = 15). Participants completed a supervised 4-week Pilates program (3 sessions/week, moderate intensity). Resting heart rate (HR), systolic and diastolic blood pressure (SBP, DBP), body mass index (BMI), abdominal circumference (ABD), fasting blood glucose (GLU), and serum cortisol (CORT) were assessed at baseline (T0) and post-intervention (T1). Within-group changes were analyzed using paired Student’s t-tests, between-group differences using ANOVA, and associations between variables using Pearson correlation analysis. Results: Both groups demonstrated favorable cardiovascular, metabolic, and neuroendocrine adaptations following the intervention. In the 30–40 years group, significant reductions were observed in HR (Δ = −10.7 ± 3.2 bpm, p < 0.0001), BMI (Δ = −1.61 ± 0.4 kg/m2, p = 0.0050), and GLU (Δ = −9.7 ± 6.1 mg/dL, p = 0.0044). In the 50–60 years group, significant reductions were observed in SBP (Δ = −10.8 ± 3.1 mmHg, p = 0.0001), DBP (Δ = −7.1 ± 2.4 mmHg, p = 0.0001), GLU (Δ = −11.9 ± 7.3 mg/dL, p = 0.0051), and CORT (Δ = −54.9 ± 22 nmol/L, p = 0.0422). Between-group analyses demonstrated significantly greater reductions in SBP, DBP, BMI, and CORT, whereas changes in HR, ABD, and GLU did not differ significantly between age groups. Pearson correlation analysis revealed significant associations between cardiovascular, metabolic, and neuroendocrine adaptations, particularly between HR and BP responses in the younger group, and between BMI and GLU changes in the older group. Conclusions: A 4-week structured Pilates program induced favorable cardiovascular, metabolic, anthropometric, and neuroendocrine adaptations in previously sedentary adult women, with significant age-related differences observed for blood pressure, body mass index, and serum cortisol responses. These findings support Pilates as a multidimensional exercise intervention for cardiometabolic and stress regulation.