Sex Differences in Cardiovascular Adaptations Following Aerobic Exercise Training Programs: A Systematic Review and Meta-Analysis

Lisa M Cotie; Isabela R Marçal; Kimberley L Way; Leanna S Lee; Megan Patterson; Mitchell Pearson; Emilia Main; Jane S Thornton; Jennifer L Reed; Laura Banks

doi:10.1016/j.cjca.2024.12.005

Sex Differences in Cardiovascular Adaptations Following Aerobic Exercise Training Programs: A Systematic Review and Meta-Analysis

Can J Cardiol. 2024 Dec 7:S0828-282X(24)01245-5. doi: 10.1016/j.cjca.2024.12.005. Online ahead of print.

Authors

Affiliations

¹ KITE Research Institute, Toronto Rehabilitation Institute - University Health Network Toronto, ON, Canada.
² Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
³ Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia.
⁴ Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
⁵ School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada.
⁶ Department of Physiology, University of Alberta, Edmonton, Alberta, Canada.
⁷ Western Centre for Public Health & Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
⁸ Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
⁹ KITE Research Institute, Toronto Rehabilitation Institute - University Health Network Toronto, ON, Canada; Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada. Electronic address: [email protected].

PMID: 39653240
DOI: 10.1016/j.cjca.2024.12.005

Abstract

Background: The influence of aerobic exercise training on cardiovascular adaptations in healthy males versus females is unclear. This systematic review and meta-analysis summarized sex-based differences in cardiac adaptations following aerobic exercise training interventions in healthy adults.

Methods: Five electronic databases were searched from inception to June 2024. Cardiac adaptation data included V̇O₂peak, HR, a-vO2diff, SBP, DBP, stroke volume, cardiac output, LV mass, LVEDV, LVESV, and LVEF. Meta-analyses were conducted in RevMan 5.4.

Results: Meta-analyses were conducted on four outcomes: LV mass, LVEDV, LVESV, and LVEF. The meta-analysis revealed no sex differences in LV mass (SMD=-0.01, 95% CI: -0.29, 0.27, P=0.97), LVESV (MD=1.85,95% CI: -3.45, 7.10, P=0.5) or LVEF (MD=-0.9, 95% CI: -3.26, 1.46, P=0.45) following aerobic exercise interventions. Meta-analyses revealed a sex difference in LVEDV; males show a greater improvement in LVEDV (MD=7.67, 95% CI: 2.75, 12.59, P=0.002) than females after aerobic exercise training. No other sex differences were observed in any of the other outcomes. The overall risk of bias was low, and quality of evidence was moderate.

Conclusions: Aerobic exercise interventions were associated with a larger increase in LVEDV in males relative to females; yet no sex differences were found in cardiac morphology (LV mass) or functional indices (LVEF).

Keywords: LV mass; LVEDV; LVEF; LVESV; aerobic exercise training; cardiac adaptations; cardiorespiratory fitness.

Publication types

Review