Effects of resistance training on endothelial function: A systematic review and meta-analysis

The effects of resistance training on flow-mediated dilation (FMD), which has been the gold standard non-invasive assessment of endothelial function and is associated with the risk of cardiovascular events, are not well known. We conducted a systematic review to analyze the effects of resistance training on FMD.

We searched Pubmed, Embase, CINAHL, SPORTDiscuss, Scopus, Web of Science and PEDro databases for studies that met the following criteria: (a) randomized controlled trials of resistance exercise with a comparative non-exercise group or contralateral untrained limb in adults and/or elderly; (b) studies that measured post-occlusion brachial artery FMD by ultrasonography, before and after intervention. Mean differences (MDs) with 95 % confidence interval (95 % CI) were calculated using an inverse variance method with a random effects model.

Twenty-three studies were included in the meta-analysis (n = 785 participants; 53 % females). Resistance training on FMD responses showed a favorable result for the resistance training group (n = 366) compared to the control group (n = 358) (MD 2.39, 95%CI 1.65, 3.14; p<0.00001). Subgroup analysis indicated favorable results for the dynamic resistance training (n = 545; MD 2.12, 95 % CI 1.26, 2.98; p<0.00001) and isometric handgrip training (n = 179; MD 3.32, 95 % CI 1.68, 4.96; p<0.0001) compared to the control group. The effect of resistance training on FMD responses was also favorable regardless of the condition of the participants (Healthy [n = 261]: MD 2.11, 95 % CI 1.04, 3.18; p<0.0001; Cardiovascular disease [n = 310]: MD 2.89, 95 % CI 0.88, 4.90; p = 0.005; metabolic disease [n = 153]: MD 2.40, 95 % CI 1.59, 3.21; p<0.00001).

Resistance training improves FMD in healthy individuals and patients with cardiovascular and metabolic diseases.