What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Arterial stiffness (n=1270). Intervention: Aerobic exercise, resistance training, and stretching vs. Inactive comparator. Primary outcome: Longitudinal arterial stiffness (ES -1.11).

What question did this study set out to answer?

To examine how different types of exercises affect arterial stiffness both acutely and chronically.

July 23, 2026Scientific Reports0 citationsOpen Access

Acute and chronic arterial stiffness responses to stretching, aerobic, and resistance exercise: a systematic review and meta-analysis of randomized controlled trials

ETEwan ThomasUniversity of Palermo GPGianmarco PintoUniversity of Palermo SFSalvatore FrendaUniversity of Palermo

Key Result

Aerobic exercise produced significant longitudinal reductions in arterial stiffness (ES -1.11), while stretching induced moderate longitudinal improvements (ES -0.63) and resistance training showed no significant effect.

Key Points

To examine how different types of exercises affect arterial stiffness both acutely and chronically.
Conducted systematic review and meta-analysis of randomized controlled trials and crossover studies
Included 41 studies with 1270 participants comparing stretching, aerobic, and resistance exercises against inactive comparators
Analyzed outcomes using pulse wave velocity, β-stiffness index, and cardio-ankle vascular index.
Stretching showed moderate chronic improvements in arterial stiffness (ES = -0.63) but no significant acute effects (ES = -0.15).
Aerobic exercise led to significant chronic reductions (ES = -1.11) and moderate acute reductions (ES = -0.62).
Resistance training showed no significant effects (ES = -0.41 for chronic; ES = 0.00 for acute), with small benefits in low-intensity protocols.

Study Design

Type

Meta-Analysis (n=1,270)

Structured PICO

Do stretching, aerobic exercise, and resistance training reduce arterial stiffness compared to an inactive comparator?

Population

1,270 healthy and clinical participants from 41 randomized controlled trials evaluating the acute and longitudinal effects of stretching, aerobic, and resistance exercise on arterial stiffness.

Intervention

Stretching (ST), aerobic exercise (AE), and resistance training (RT)

Comparator

Inactive comparator

Outcome

Arterial stiffness (measured by pulse wave velocity [PWV], β-stiffness index, and cardio-ankle vascular index [CAVI])surrogate

Aerobic exercise and stretching are associated with chronic reductions in arterial stiffness, whereas resistance training effects vary by intensity.

Main Result

Standardized Mean Difference: -1.11

Limitations

Most included studies had 'some concerns' in the risk of bias assessment.
Overall certainty of evidence was rated as 'very low' according to GRADE.
Substantial heterogeneity in the reporting of stretching intensity.

Abstract

This study examined the acute and chronic effects of stretching (ST), aerobic exercise (AE), and resistance training (RT) on arterial stiffness through a systematic review and meta-analysis of randomized controlled trials and randomized crossover studies. Following registration on PROSPERO, searches were conducted in Scopus, PubMed (NLM), and Web of Science to identify studies comparing ST, AE, and RT with an inactive comparator, examining pulse wave velocity (PWV), β-stiffness index, and cardio-ankle vascular index (CAVI). Forty-one studies were included (1270 participants; ST = 7, AE = 19, RT = 17). Effects were calculated as Hedges’ g with 95% confidence intervals using random-effects models, separately for acute and longitudinal interventions. ST induced moderate chronic improvements (ES = − 0.63) but showed no significant acute effect (ES = − 0.15). AE produced significant chronic reductions (ES = − 1.11) and moderate acute reductions (ES = − 0.62), while RT showed no significant effects neither for the longitudinal (ES = − 0.41) or acute (ES = 0.00) interventions, with small benefits observed only following low-intensity protocols. According to the RoB assessment, most studies had “some concerns”, and overall certainty of evidence was rated as “very low” according to GRADE. Overall, AE was consistently associated with reductions in arterial stiffness across most modality-specific analyses. ST demonstrated favorable chronic effects. The effects of RT appeared to vary according to exercise intensity, population characteristics, and analytical model. PROSPERO registration number : CRD420250653424.

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