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. 2025 May 19.
doi: 10.1007/s40279-025-02238-x. Online ahead of print.

Impacts of Physical Inactivity Models on Endothelial Function: A Systematic Review

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Impacts of Physical Inactivity Models on Endothelial Function: A Systematic Review

Joel E Harden et al. Sports Med. .

Abstract

Background: Endothelial dysfunction is associated with cardiovascular disease and cardiac events. Numerous studies demonstrate that a reduction in physical activity/exercise levels are associated with poor endothelial function. Yet, these studies use a plethora of models to mimic reduced activity levels which may have widely different results on endothelial function. It is pertinent to collectively review these articles to provide a comprehensive understanding of the impact of reduced activity on vascular health, as endothelial function is one of many factors that influences vascular tone.

Objective: The purpose of this systematic review is to examine and synthesize the current literature regarding the effects of acutely (≤ ~ 2 months) reducing physical activity on endothelial function.

Methods: This systematic review contains a search of two databases (PubMed, Web of Science) conducted by two reviewers. After screening and review, the search yielded 20 studies that were appraised and reviewed.

Results: Articles were separated into four categories based on the type of inactivity intervention: reduction in daily physical activity interventions, detraining (removal of exercise) interventions, bed rest interventions, and immobilization interventions. Acute physical inactivity interventions were largely shown to reduce upper and lower limb artery flow-mediated dilation and lower limb microvascular function.

Conclusion: The results indicate that those studies with increased time spent in inactivity, as well as increased severity of inactivity, were more likely to have negative endothelial function outcomes. Future research should examine differences in the severity of physical inactivity interventions regarding endothelial function.

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Conflict of interest statement

Declarations. Funding: The authors did not receive support from any organization for the submitted work. Conflict of Interest: The authors have no competing interests to declare that are relevant to the content of this article. Availability of Data and Materials: All studies from which data were examined are cited in the references section. Ethics Approval: Ethics approval was not required as the current paper is a systematic review. Author Contributions: All authors contributed to the paper conception and design. Manual literature search and review of articles for inclusion in the review was done by Joel Harden and Leryn Reynolds. The first draft of the manuscript was written by Joel Harden, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. Informed Consent: Informed consent for subjects within the studies that this review encompasses was obtained for all relevant studies by the researchers conducting those studies.

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