Pierce Gary L
Department of Health and Human Physiology, University of Iowa, Iowa City, IA, USA.
Department of Internal Medicine, University of Iowa, Iowa City, IA, USA.
Pulse (Basel). 2024 Dec 10;13(1):22-30. doi: 10.1159/000542610. eCollection 2025 Jan-Dec.
Aortic stiffness, quantified by carotid-femoral pulse wave velocity (PWV), is a strong predictor of cardiovascular disease events. In general, dynamic "aerobic" exercise training performed regularly for many years in middle and older age is associated with an attenuated or absence of an age-related increase in aortic stiffness without hypertension. However, cross-sectional studies can be confounded by physiological or lifestyle factors that may contribute in part to the lower aortic stiffness observed, and prospective interventions are often limited by short duration and inadequate exercise frequency to have clinical benefit. Therefore, this review will discuss the evidence for the de-stiffening effects of regular, dynamic aerobic exercise training on aortic stiffness in the presence or absence of hypertension with some discussion on high-intensity interval training (HIIT).
Short-term (3-12 months) aerobic exercise interventions, 2-3 days per week initiated in middle age or older age without hypertension, result in small decreases in carotid-femoral PWV that is likely the result of reductions in distending pressure (i.e., mean arterial pressure) rather than an alteration in structural wall properties. However, cross-sectional data indicate that 4-5 days/week appears to be the minimal frequency that is obligatory for de-stiffening of the aorta among adults who perform regular exercise in middle age and continue into older age. Despite greater improvements in aerobic fitness by high-intensity interval training (HIIT), short-term HIIT 4 days/week does not provide any benefit over moderate-intensity continuous training for de-stiffening the aorta among older adults with or without hypertension.
Short-term aerobic exercise interventions 2-3 days/week at moderate intensity initiated in middle age or older age have small or no favorable blood pressure-independent effect on aortic wall stiffness. In contrast, 4-5 days/week appears to be the minimal obligatory dose of aerobic exercise to have some de-stiffening effects if performed during middle age and continuing into older age. Short-term HIIT provides no greater de-stiffening effects on the aged aorta than continuous aerobic exercise training.
通过颈股脉搏波速度（PWV）量化的主动脉僵硬度是心血管疾病事件的有力预测指标。一般来说，中年及老年人群多年定期进行的动态“有氧运动”训练与主动脉僵硬度随年龄增长的增加减弱或不存在相关，且无高血压。然而，横断面研究可能会受到生理或生活方式因素的混淆，这些因素可能部分导致观察到的较低主动脉僵硬度，前瞻性干预措施往往受限于持续时间短和运动频率不足而无法产生临床益处。因此，本综述将讨论在有或无高血压情况下，定期进行动态有氧运动训练对主动脉僵硬度的去僵硬度作用的证据，并对高强度间歇训练（HIIT）进行一些讨论。
在无高血压的中年或老年人群中开始的短期（3 - 12个月）有氧运动干预，每周2 - 3天，会使颈股PWV略有下降，这可能是由于扩张压力（即平均动脉压）降低而非血管壁结构特性改变所致。然而，横断面数据表明，对于从中年开始定期锻炼并持续到老年的成年人，每周4 - 5天似乎是使主动脉去僵硬度的最低频率。尽管高强度间歇训练（HIIT）能更好地改善有氧适能，但对于有或无高血压的老年人，每周4天的短期HIIT在使主动脉去僵硬度方面并不比中等强度持续训练更有益。
在中年或老年开始的每周2 - 3天中等强度的短期有氧运动干预对主动脉壁僵硬度几乎没有或没有独立于血压的有利影响。相比之下，如果从中年开始并持续到老年，每周4 - 5天似乎是产生一些去僵硬度效果的最低有氧运动剂量。短期HIIT对老年主动脉的去僵硬度作用并不比持续有氧运动训练更大。
