Resistance Training Improves Hemodynamics Involving Autonomic and Immune Responses

Abstract

Aging impairs cardiovascular, autonomic and immune responses. Whether the resistance training influences such responses is unknown. We tested the hypothesis that resistance training could attenuate such impairments in older adults. Sixty-eight older adults were randomized into a control group (n=38) and a training group (n=31). Resistance training sessions were conducted three times per week, 12-week period, at a moderate intensity (65%–80% of 1 RM). Cardiovascular hemodynamics were evaluated by impedance cardiography (PhysioFlow), electrocardiogram including autonomic imbalance, a 1 minute sit-to-stand test including partial oxygen saturation (SpO₂) monitoring, maximal expiratory pressure, maximal inspiratory pressure, whole blood analysis and pro- and anti-inflammatory cytokines in plasma. After 12 weeks of resistance training, an improvement in stroke volume (p<0.0092), cardiac output (p<0.0235), systemic vascular resistance (p<0.0424), end diastolic volume (p<0.0053), early diastolic function (p<0.0398), pNN50 (p<0.0485), and the TRI (p<0.0029) was observed when comparing pre- versus post-intervention in the resistance training group. Resistance training also improved maximal expiratory pressure (p<0.0036) and maximal inspiratory pressure (p<0.0034). Functional capacity in the 1- minute sit-to-stand test (p<0.0004) and oxygen desaturation (p<0.0008) were improved in the resistance training group. In addition, resistance training decreased serum levels of pro-inflammatory cytokines, interleukin-6 (p<0.0001) and tumor necrosis factor alpha (p<0.043), and increased anti-inflammatory cytokines, interleukin-10 (p<0.0003) and protein klotho (p<0.0001). Resistance training improves cardiovascular hemodynamics, autonomic imbalance and immune response in older adults, while the control group did not show any evolution.

Keywords

aging - older adults - autonomic balance - immune response - resistance training

Publikationsverlauf

Eingereicht: 06. Februar 2025

Angenommen nach Revision: 01. Oktober 2025

Artikel online veröffentlicht:
21. November 2025

• References

• 1 Kanasi E, Ayilavarapu S, Jones J. The aging population: demographics and the biology of aging. Periodontol 2000 2016; 72: 13-18
• 2 Lopez-Otin C, Blasco MA, Partridge L. et al. The hallmarks of aging. Cell 2013; 153: 1194-1217
• 3 Howden EJ, Sarma S, Lawley JS. et al. Reversing the Cardiac Effects of Sedentary Aging in Middle Age-A Randomized Controlled Trial: Implications For Heart Failure Prevention. Circulation 2018; 137: 1549-1560
• 4 Giunta S, Xia S, Pelliccioni G. et al. Autonomic nervous system imbalance during aging contributes to impair endogenous anti-inflammaging strategies. Geroscience 2024; 46: 113-127
• 5 Jiang Y, Yabluchanskiy A, Deng J. et al. The role of age-associated autonomic dysfunction in inflammation and endothelial dysfunction. Geroscience 2022; 44: 2655-2670
• 6 Bachi ALL, Abbasi A, Durigan JLQ. et al. Editorial: The role of latent chronic infection in immunosenescence and inflamm-aging. Front Immunol 2023; 14: 1285234
• 7 Ramos AM, Pellanda LC, Gus I. et al. Inflammatory markers of cardiovascular disease in the elderly. Arq Bras Cardiol 2009; 92: 221-228, 227–234
• 8 Buchanan S, Combet E, Stenvinkel P. et al. Klotho, Aging, and the Failing Kidney. Front Endocrinol (Lausanne) 2020; 11: 560
• 9 Kuro-o M. Klotho and aging. Biochim Biophys Acta 2009; 1790: 1049-1058
• 10 Tylutka A, Walas L, Zembron-Lacny A. Level of IL-6, TNF, and IL-1beta and age-related diseases: a systematic review and meta-analysis. Front Immunol 2024; 15: 1330386
• 11 Garber CE, Blissmer B, Deschenes MR. et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc 2011; 43: 1334-1359
• 12 Umpierre D, Stein R. Hemodynamic and vascular effects of resistance training: implications for cardiovascular disease. Arq Bras Cardiol 2007; 89: 256-262
• 13 Faul F, Erdfelder E, Lang AG. et al. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007; 39: 175-191
• 14 Ansari M, Javadi H, Pourbehi M. et al. The association of rate pressure product (RPP) and myocardial perfusion imaging (MPI) findings: a preliminary study. Perfusion 2012; 27: 207-213
• 15 Barbalho M, Gentil P, Raiol R. et al. High 1RM Tests Reproducibility and Validity are not Dependent on Training Experience, Muscle Group Tested or Strength Level in Older Women. Sports (Basel) 2018; 6
• 16 ACSM. ACSM’s Guidelines for Exercise Testing and Prescription. 11th edn 2021. Wolters Kluwer Health, under the imprint Lippincott Williams & Wilkins (LWW), in Philadelphia, United States
• 17 Moura-Maia MS, Brill B, Paula-Vieira RHR. et al. Low Caloric Intake Confers Cardiovascular Protection and Improves Functional Capacity Without Affecting Immunological Response in Sedentary Older Adults. Nutrients 2024; 16
• 18 Schoch R, Wagner J, Niemeyer M. et al. Reliability of hemodynamic parameters measured by bioimpedance cardiography at different intensities during incremental exercise testing. Front Cardiovasc Med 2025; 12: 1531027
• 19 Zarate SM, Kirabo A, Hinton AO. et al. Neuroimmunology of Cardiovascular Disease. Curr Hypertens Rep 2024; 26: 339-347
• 20 Aquino-Santos HC, Tavares-Vasconcelos JS, Brandao-Rangel MAR. et al. Chronic alteration of circadian rhythm is related to impaired lung function and immune response. Int J Clin Pract 2020; 74: e13590
• 21 Sammito S, Bockelmann I. Reference values for time- and frequency-domain heart rate variability measures. Heart Rhythm 2016; 13: 1309-1316
• 22 Cahalin LP, Semigran MJ, Dec GW. Inspiratory muscle training in patients with chronic heart failure awaiting cardiac transplantation: results of a pilot clinical trial. Phys Ther 1997; 77: 830-838
• 23 Kronberger C, Mousavi RA, Ozturk B. et al. Exercise capacity assessed with the one-minute sit-to-stand test (1-min STST) and echocardiographic findings in patients with heart failure with preserved ejection fraction (HFpEF). Heart Lung 2022; 55: 134-139
• 24 Taya M, Amiya E, Hatano M. et al. Clinical importance of respiratory muscle fatigue in patients with cardiovascular disease. Medicine (Baltimore) 2020; 99: e21794
• 25 Briand J, Behal H, Chenivesse C. et al. The 1-minute sit-to-stand test to detect exercise-induced oxygen desaturation in patients with interstitial lung disease. Ther Adv Respir Dis 2018; 12: 1753466618793028
• 26 Cruz-Jentoft AJ, Baeyens JP, Bauer JM. et al. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing 2010; 39: 412-423
• 27 Ogburn-Russell L, Johnson JE. Oxygen saturation levels in the well elderly: altitude makes. a differenceJ Gerontol Nurs 1990; 16: 26-30
• 28 Aguirre LE, Villareal DT. Physical Exercise as Therapy for Frailty. Nestle Nutr Inst Workshop Ser 2015; 83: 83-92
• 29 Bohannon RW, Crouch R. 1-Minute Sit-to-Stand Test: SYSTEMATIC REVIEW OF PROCEDURES, PERFORMANCE, AND CLINIMETRIC PROPERTIES. J Cardiopulm Rehabil Prev 2019; 39: 2-8
• 30 Wei Y, Giunta S, Xia S. Hypoxia in Aging and Aging-Related Diseases: Mechanism and Therapeutic Strategies. Int J Mol Sci 2022; 23: 8165
• 31 Stoschitzky K. Blood pressure, heart rate, or the Rate Pressure Product: what is the best predictor of clinical outcome?. Eur Heart J Open 2022; 2: oeac063
• 32 Benetos A, Petrovic M, Strandberg T. Hypertension Management in Older and Frail Older Patients. Circ Res 2019; 124: 1045-1060
• 33 Correia RR, Veras ASC, Tebar WR. et al. Strength training for arterial hypertension treatment: a systematic review and meta-analysis of randomized clinical trials. Sci Rep 2023; 13: 201
• 34 de Sousa EC, Abrahin O, Ferreira ALL. et al. Resistance training alone reduces systolic and diastolic blood pressure in prehypertensive and hypertensive individuals: meta-analysis. Hypertens Res 2017; 40: 927-931
• 35 Chou CH, Yin JH, Lin YK. et al. The optimal pulse pressures for healthy adults with different ages and sexes correlate with cardiovascular health metrics. Front Cardiovasc Med 2022; 9: 930443
• 36 Cornelissen VA, Fagard RH. Effects of endurance training on blood pressure, blood pressure-regulating mechanisms, and cardiovascular risk factors. Hypertension 2005; 46: 667-675
• 37 Gaitan JM, Moon HY, Stremlau M. et al. Effects of Aerobic Exercise Training on Systemic Biomarkers and Cognition in Late Middle-Aged Adults at Risk for Alzheimer’s Disease. Front Endocrinol (Lausanne) 2021; 12: 660181
• 38 Bertovic DA, Waddell TK, Gatzka CD. et al. Muscular strength training is associated with low arterial compliance and high pulse pressure. Hypertension 1999; 33: 1385-1391
• 39 Azambuja ACM, de Oliveira LZ, Sbruzzi G. Inspiratory Muscle Training in Patients With Heart Failure: What Is New? Systematic Review and Meta-Analysis. Phys Ther 2020; 100: 2099-2109
• 40 Blattner C, Guaragna JC, Saadi E. Oxygenation and static compliance is improved immediately after early manual hyperinflation following myocardial revascularisation: a randomised controlled trial. Aust J Physiother 2008; 54: 173-178
• 41 Cader SA, Vale RG, Castro JC. et al. Inspiratory muscle training improves maximal inspiratory pressure and may assist weaning in older intubated patients: a randomised trial. J Physiother 2010; 56: 171-177
• 42 Smith JR, Taylor BJ. Inspiratory muscle weakness in cardiovascular diseases: Implications for cardiac rehabilitation. Prog Cardiovasc Dis 2022; 70: 49-57
• 43 Cordova C, Lopes ESF, Pires AS. et al. Long-term resistance training is associated with reduced circulating levels of IL-6, IFN-gamma and TNF-alpha in elderly women. Neuroimmunomodulation 2011; 18: 165-170
• 44 Fernandez-Rodriguez R, Monedero-Carrasco S, Bizzozero-Peroni B. et al. Effectiveness of Resistance Exercise on Inflammatory Biomarkers in Patients with Type 2 Diabetes Mellitus: A Systematic Review with Meta-Analysis. Diabetes Metab J 2023; 47: 118-134
• 45 Smart NA, Larsen AI, Le Maitre JP. et al. Effect of exercise training on interleukin-6, tumour necrosis factor alpha and functional capacity in heart failure. Cardiol Res Pract 2011; 2011: 532620
• 46 Yu X, Yang Z, Yu M. Correlation of tumor necrosis factor alpha and interleukin 6 with hypertensive renal damage. Ren Fail 2010; 32: 475-479
• 47 Rispoli RM, Popolo A, De Fabrizio V. et al. Targeting Inflammatory Imbalance in Chronic Kidney Disease: Focus on Anti-Inflammatory and Resolution Mediators. Int J Mol Sci 2025; 26: 3072
• 48 Gullestad L, Ueland T, Vinge LE. et al. Inflammatory cytokines in heart failure: mediators and markers. Cardiology 2012; 122: 23-35
• 49 Li Y, Yin H, Yuan H. et al. IL-10 deficiency aggravates cell senescence and accelerates BLM-induced pulmonary fibrosis in aged mice via PTEN/AKT/ERK pathway. BMC Pulm Med 2024; 24: 443