We conducted a systematic review of randomized clinical trials evaluating the effects of aerobic, resistance and/or combined training on flow-mediated dilation (FMD) and/or pulse wave velocity (PWV) in older adults. The studies were selected from the electronic databases PubMed, Cochrane, LILACS, EMBASE, Web of Science, and the gray literature. We assessed the studies using Cochrane risk of bias (RoB2) tool and the GRADE tool. The GRADE assessment showed moderate quality of evidence for aerobic training and resistance training and very low for combined training. The measures of effects are presented as mean differences of the intervention group versus the control group and related 95% confidence intervals (95% CIs) pooled by a random-effects model using an inverse variance method. Our analysis of 24 RCTs (Intervention group [n = 251]: 67.7 ± 5.6 years old; control group [n = 228]: 68.7 ± 5.9 years old) showed that aerobic training was effective to improve FMD (0.64% [95% CI 0.24 to 1.03], p = 0.002) and PWV (–1.21 m/s [95% CI –1.37 to –1.05], p< 0.001) by compared to the control group. The subgroup analyses showed no FMD differences following aerobic training in healthy adults when compared to those with any health condition. Combined training was effective in improving FMD (0.60% [95% CI 0.50 to 0.71], p< 0.001) and PWV (-0.79 m/s [95% CI –1.23 to –0.35], p = 0.002). But these same parameters did not show any improvement in response to resistance training. A major limitation of this study is that the analysis to evaluate the effect of resistance training on PWV include only one study, and no inferences could be made from the data. Aerobic and combined training, but not resistant training, improve flow-mediated dilation and pulse wave velocity in the elderly. PROSPERO: CRD42021275282.

Resumo Fundamento: A hipertensão sustentada pode levar ao remodelamento vascular e lesão das células endoteliais, o que pode explicar a disfunção endotelial encontrada em hipertensos. O treinamento físico pode melhorar a saúde vascular em indivíduos com risco cardiovascular, mas pouco se sabe sobre seus efeitos em pré-hipertensos e hipertensos. Objetivo: Revisar a literatura mostrando evidências de alterações da função endotelial em resposta a diferentes modalidades de treinamento físico em pré-hipertensos e hipertensos. Métodos: Realizamos uma revisão sistemática de estudos nas [...] Resumo Fundamento: A hipertensão sustentada pode levar ao remodelamento vascular e lesão das células endoteliais, o que pode explicar a disfunção endotelial encontrada em hipertensos. O treinamento físico pode melhorar a saúde vascular em indivíduos com risco cardiovascular, mas pouco se sabe sobre seus efeitos em pré-hipertensos e hipertensos. Objetivo: Revisar a literatura mostrando evidências de alterações da função endotelial em resposta a diferentes modalidades de treinamento físico em pré-hipertensos e hipertensos. Métodos: Realizamos uma revisão sistemática de estudos nas

Context: Energy drinks (EDs) are beverages that contain ingredients that may pose a risk to consumers’ cardiovascular health. But current evidence is conflicting and warrants further investigation.Objective: A systematic review and meta-analysis was conducted on studies that examined the acute effects of ED consumption on systolic blood pressure (SBP), diastolic blood pressure (DBP), resting heart rate, cardiac output (CO), endothelial function, and QT/QTc interval in healthy adults.Data Sources: The databases PubMed, EMBASE, Cochrane, LILACS, Web of Science, SportDiscus, and the gray literature were searched to identify randomized controlled trials (RCTs).Data Extraction: Two independent evaluators screened 2014 studies and extracted relevant data from those selected for the analysis. A risk of bias assessment was also performed with the RoB 2 tool and a strength of evidence assessment was performed with the Grading of Recommendations Assessment, Development and Evaluation (GRADE).Data Analysis: A total of 17 RCTs were included in the meta-analysis. With regard to risk of bias, 11 studies were rated as having “some concerns” and 6 as “high risk of bias.” The consumption of EDs increased SBP, DBP, and CO in different time frames. More pronounced effects were seen on SBP at 60-80 minutes (4.71 mmHg; 95% CI: 2.97–6.45; GRADE: moderate), DBP at 120 minutes (4.51 mmHg; 95% CI: 2.60–6.42; GRADE: low), and CO at 30-40 minutes after consumption (0.43 L; 95% CI: 0.08–0.77; GRADE: very low). The effects of ED consumption on resting heart rate and QT/QTc interval were not significant (P ≤ 0.05). The assessment of endothelial function effects was not performed due to the absence of any RCTs meeting the inclusion criteria.Conclusions: Acute consumption of EDs increases SBP, DBP, and CO in healthy adults. However, no alterations were observed in other cardiovascular parameters. The results should be interpreted with caution due to the limited number of studies included in the analysis.Systematic Review Registration: PROSPERO registration no. CRD42022295335.

Background: Cardiac rehabilitation with aerobic exercises is the first strategy for nonpharmacological treatment in the postoperative period of individuals undergoing coronary artery bypass grafting (CABG) to improve functional capacity and vascular health. However, other exercise modalities remain uncertain regarding the same benefits. Objectives: Evaluation of the effect of different modalities of exercise, such as early cardiac rehabilitation on subjects submitted to CABG in the six-minute walk test (6-MWT) and on the percentage of flow-mediated dilatation (FMD) of the brachial artery. Methods: A randomized clinical trial in which 15 patients (62.7 ± 6.7 years) who underwent CABG were randomly assigned to the following groups: isometric (IG, Handgrip Jamar^®), ventilatory muscle training (VG, PowerBreathe^®) and control (CG, conventional respiratory and motor physiotherapy). All patients were attended to physically twice a day (20 min/session) for a consecutive week after the CABG (hospital admission). Functional capacity was assessed by 6-MWT and endothelial function was assessed through the technique of FMD, before and after (~7 days) admission to CABG. The doppler ultrasound videos were analyzed by Cardiovascular Suite^® software (Quipu, Pisa, Italy) to measure %FMD. Statistics: Generalized estimation equation, followed by Bonferroni post hoc (p < 0.05). Results: Systolic, diastolic and mean arterial pressure (SBP/DBP/MAP, respectively) were 133, 76 and 95 mmHg. The groups presented walking meters (m) distance before and after intervention of: IG_basal 357.80 ± 47.15 m vs. IG_post 306.20 ± 61.63 m, p = 0.401 (+51 m); VG_basal 261.50 ± 19.91 m vs. VG_post 300.75 ± 26.29 m, p = 0.052 (+39 m); CG _basal 487.83 ± 83.23 m vs. CG_post 318.00 ± 31.08, p = 0.006 (−169 m). %FMD before and after intervention was IG_basal 10.4 ± 4.8% vs. IG_post 2.8 ± 2.5%, p = 0.152; VG_basal 9.8 ± 5.1% vs. VG_post 11.0 ± 6.1%, p = 0.825; CG_basal 9.2 ± 15.8% vs. CG_post 2.7 ± 2.6%, p = 0.710 and resting mean basal blood flow was IG_basal 162.0 ± 55.0 mL/min vs. IG_post 129.9 ± 63.7 mL/min, p = 0.662; VG_basal 83.74 ± 12.4 mL/min vs. VG_post 58.7 ± 17.1 mL/min, p = 0.041; CG_basal 375.6 ± 183.7 mL/min vs. CG_post 192.8 ± 115.0 mL/min, p = 0.459. Conclusions: Ventilatory muscle training for early cardiac rehabilitation improved acute functional capacity and modulated mean flow of individuals undergoing CABG.

Endothelial dysfunction is a hallmark of diabetes mellitus and systemic arterial hypertension (SAH) and an early maker for atherosclerosis. Aerobic exercise training is known to enhance endothelial function, but little is understood about the effects of resistance or combined exercise training on endothelial function. The aim of this study is to investigate the effect of a 12-week aerobic (AT), resistance (RT), or combined (aerobic and resistance, CT) training program on endothelial function and assess associated effects on blood pressure in individuals with SAH. Eighty-one subjects with SAH aged 18 to 70 years will be selected and randomly assigned to three types of exercise training: AT, RT or CT. The study will involve the following procedures and tests: anamnesis, anthropometric assessment, echocardiography, blood pressure measurements through ambulatory blood pressure monitoring, flow-mediated dilation, ergospirometry, one repetition maximum test (1-RM), and blood collection (number of circulating endothelial progenitor cells, number of circulating endothelial microparticles, lipid profile, glucose, glycated hemoglobin, and creatinine). The AT intervention will consist of a 40-min exercise session with progressive intensities ranging from 50 to 75 % of heart rate reserve. The RT intervention will consist of a 40-minute session with four sets of six to 12 repetitions with a rest period of 60 to 90 seconds between each set and each type of exercise. Weight loads will be adjusted to 60 to 80 % of 1-RM for six types of exercise. The CT intervention will consist of a 20-min aerobic exercise session, followed by an additional 20-min resistance exercise session; each resistance exercise will have two sets less to match the total training volume. The study results are expected evidence of cardiovascular protective effects of different types of exercise training through the modulation of endothelial function in hypertensive individuals. Knowing the magnitude of improvement of endothelium-dependent vasodilation for the different types of exercise training can provide scientific evidence for the prescription of exercise programs for vascular protection targeting hypertensive individuals. The Brazilian Clinical Trials Registry ( http://www.ensaiosclinicos.gov.br/ ) under RBR-9ygmdn and dated 1 March 2015.