Adverse Cardiovascular Response to Aerobic Exercise Training: Is This a Concern?

Med Sci Sports Exerc. 2016 Jan;48(1):20-5. doi: 10.1249/MSS.0000000000000752.

Abstract

Purpose: Aerobic exercise training in sedentary individuals improves physical fitness and various cardiovascular (CV) biomarkers. Nevertheless, there has been controversy as to whether exercise training may adversely affect some biomarkers in a small segment of the population. The purpose of this study was to investigate whether clinically significant worsening of CV biomarkers was more prevalent among individuals randomized to a supervised endurance training program as compared with those randomized to a control condition.

Methods: Baseline and end of study measurements of fasting insulin (FI), triglycerides (TG), resting systolic blood pressure (SBP), and HDL cholesterol (HDL-C) were obtained on 1188 healthy sedentary subjects from 4 clinical studies. Each study randomized subjects to 4- to 6-month supervised aerobic exercise programs or to a control group of no supervised exercise training. For each of the 4 CV biomarkers, we calculated the respective proportions of control and exercise group subjects whose baseline-to-follow-up changes were greater than or equal to previously reported adverse change (AC) thresholds. Those thresholds were increases of 24 pmol · L(-1) or greater for FI, 0.42 mmol · L(-1) or greater for TG, 10 mm Hg or greater for SBP, and a decrease of 0.12 mmol · L(-1) or greater for HDL-C.

Results: The respective proportions of subjects meeting the AC threshold in the control and exercise groups were 15.2% versus 9.6% (P = 0.02) for FI, 14.9% versus 13.1% (P = 0.37) for TG, 16.9% versus 15.8% (P = 0.52) for SBP, and 28.6% versus 22.5% (P = 0.03) for HDL-C. All were nonsignificant at the 0.0125 Bonferroni threshold adjusting for multiple comparisons.

Conclusions: These findings do not support the concept that aerobic exercise training increases the risk of adverse changes in the CV biomarkers we studied.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biomarkers / blood
  • Blood Pressure*
  • Cholesterol, HDL / blood*
  • Exercise / physiology*
  • Female
  • Humans
  • Insulin / blood*
  • Male
  • Middle Aged
  • Physical Education and Training*
  • Physical Fitness / physiology
  • Triglycerides / blood*

Substances

  • Biomarkers
  • Cholesterol, HDL
  • Insulin
  • Triglycerides