{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T21:50:23Z","timestamp":1788904223277,"version":"build-2803163510"},"reference-count":95,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Obesity is a major modifiable risk factor for atherosclerotic cardiovascular disease. This study evaluated the efficacy of different exercise modalities in improving vascular health parameters in overweight\/obese adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic review and network meta-analysis of 51 randomized controlled trials (n\u2009=\u20092638) following PRISMA and a prospectively registered PROSPERO protocol (CRD420251066443). PubMed, Web of Science, the Cochrane Library, and EBSCO SPORTDiscus were searched from inception to 31 May 2025, supplemented by Google Scholar and reference screening. Eligible trials enrolled adults aged 18\u201365 years with overweight\/obesity, included interventions lasting \u22654 weeks, and compared CET, RT, INT, CT, or HYB with usual lifestyle\/standard care. The primary outcome was FMD, with CIMT and PWV as secondary outcomes. Risk of bias was assessed using RoB 2 and certainty of evidence using CINeMA. Effects were synthesized as SMDs with 95% CIs, and modalities were compared using network meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The certainty of evidence was assessed using CINeMA, with a low confidence rating. Fifty-one trials (n\u2009=\u20092,638) met the inclusion criteria. Compared to the control group, exercise interventions led to significant improvements in Flow-Mediated Dilation (FMD) (SMD\u2009=\u20090.99, 95% CI 0.69\u20131.29), reductions in Pulse Wave Velocity (PWV) (SMD\u2009= \u22120.31, 95% CI \u22120.44 to \u22120.18), and decreases in Carotid Intima-Media Thickness (CIMT) (SMD\u2009= \u22120.20, 95% CI \u22120.36 to \u22120.05). Network meta-analysis revealed that HYB was most effective for improving FMD, INT was most effective for reducing PWV, and CET and RT exhibited similar effects on CIMT. Subgroup analyses indicated that the effects were more pronounced in women and in Asian populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Exercise interventions improve vascular health in overweight\/obese adults, with modality-specific patterns across vascular domains. HYB appears most favorable for enhancing endothelial function (FMD), INT may offer greater benefits for reducing arterial stiffness (PWV), and both CET and RT show comparable effects on structural remodeling (CIMT).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0344674","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T17:26:57Z","timestamp":1773422817000},"page":"e0344674","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["The effect of exercise intervention on atherosclerosis prevention in overweight or obese adults: A Bayesian network meta-analysis of randomized controlled 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Rubino","year":"2025","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"2","key":"pone.0344674.ref005","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.diabres.2014.04.006","article-title":"Inflammation as a link between obesity, metabolic syndrome and type 2 diabetes","volume":"105","author":"N Esser","year":"2014","journal-title":"Diabetes Res Clin Pract"},{"issue":"7121","key":"pone.0344674.ref006","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1038\/nature05487","article-title":"Mechanisms linking obesity with cardiovascular disease","volume":"444","author":"LF Van Gaal","year":"2006","journal-title":"Nature"},{"issue":"3","key":"pone.0344674.ref007","article-title":"Obesity, dyslipidemia, and cardiovascular disease: a joint expert review from the Obesity Medicine Association and the National Lipid Association 2024","volume":"18","author":"HE Bays","year":"2024","journal-title":"J Clin 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Lee","year":"2021","journal-title":"Int J Environ Res Public Health"},{"issue":"5","key":"pone.0344674.ref021","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/j.ypmed.2012.02.006","article-title":"Improvement of the lipid profile with exercise in obese children: a systematic review","volume":"54","author":"Y Escalante","year":"2012","journal-title":"Prev Med"},{"issue":"1","key":"pone.0344674.ref022","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1152\/japplphysiol.00123.2005","article-title":"Exercise-induced increase in muscle insulin sensitivity","volume":"99","author":"JO Holloszy","year":"2005","journal-title":"J Appl Physiol (1985)"},{"issue":"10","key":"pone.0344674.ref023","doi-asserted-by":"crossref","first-page":"1563","DOI":"10.1016\/j.jacc.2004.12.077","article-title":"The effects of physical activity on serum C-reactive protein and inflammatory markers: a systematic review","volume":"45","author":"C Kasapis","year":"2005","journal-title":"J Am 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Aispuru-Lanche","year":"2024","journal-title":"Ther Adv Cardiovasc Dis"},{"issue":"1","key":"pone.0344674.ref033","doi-asserted-by":"crossref","DOI":"10.1152\/ajpheart.00386.2023","article-title":"Resistance exercise lowers blood pressure and improves vascular endothelial function in individuals with elevated blood pressure or stage-1 hypertension","volume":"326","author":"NF Banks","year":"2024","journal-title":"Am J Physiol Heart Circ Physiol"},{"issue":"18","key":"pone.0344674.ref034","doi-asserted-by":"crossref","first-page":"1416","DOI":"10.1161\/CIRCULATIONAHA.123.068564","article-title":"Effects of sedentary behavior reduction on blood pressure in desk workers: results from the RESET-BP randomized clinical trial","volume":"150","author":"B Barone Gibbs","year":"2024","journal-title":"Circulation"},{"issue":"9","key":"pone.0344674.ref035","doi-asserted-by":"crossref","first-page":"2819","DOI":"10.1007\/s00421-024-05473-8","article-title":"Effect of low-volume combined aerobic and 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Ghardashi-Afousi","year":"2020","journal-title":"J Diabetes Complications"},{"key":"pone.0344674.ref044","doi-asserted-by":"crossref","first-page":"110799","DOI":"10.1016\/j.exger.2019.110799","article-title":"Cycle Training improves vascular function and neuropathic symptoms in patients with type 2 diabetes and peripheral neuropathy: a randomized controlled trial","volume":"131","author":"F Gholami","year":"2020","journal-title":"Exp Gerontol"},{"key":"pone.0344674.ref045","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1007\/s00125-020-05089-5","article-title":"Vascular improvements in individuals with type 2 diabetes following a 1 year randomised controlled exercise intervention, irrespective of changes in cardiorespiratory fitness","volume":"63","author":"M Hetherington-Rauth","year":"2020","journal-title":"Diabetologia"},{"issue":"2","key":"pone.0344674.ref046","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1111\/sms.13574","article-title":"The effect of 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Azadpour","year":"2017","journal-title":"Menopause"},{"key":"pone.0344674.ref055","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1016\/j.ijcard.2017.06.065","article-title":"Exercise individualized by TRIMPi method reduces arterial stiffness in early onset type 2 diabetic patients: a randomized controlled trial with aerobic interval training","volume":"248","author":"A Bellia","year":"2017","journal-title":"Int J Cardiol"},{"issue":"5","key":"pone.0344674.ref056","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1007\/s00421-016-3348-4","article-title":"The effects of resistance exercise training on arterial stiffness in metabolic syndrome","volume":"116","author":"E DeVallance","year":"2016","journal-title":"Eur J Appl Physiol"},{"issue":"7","key":"pone.0344674.ref057","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1097\/HJH.0000000000000946","article-title":"Improved arterial flow-mediated dilation after exertion involves hydrogen peroxide in overweight and obese adults following aerobic exercise training","volume":"34","author":"AT Robinson","year":"2016","journal-title":"J Hypertens"},{"issue":"9","key":"pone.0344674.ref058","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0138793","article-title":"Effects of high intensity interval training and strength training on metabolic, cardiovascular and hormonal outcomes in women with polycystic ovary syndrome: a pilot study","volume":"10","author":"I Almenning","year":"2015","journal-title":"PLoS One"},{"issue":"4","key":"pone.0344674.ref059","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1097\/GME.0000000000000332","article-title":"Whole-body vibration training decreases ankle systolic blood pressure and leg arterial stiffness in obese postmenopausal women with high blood pressure","volume":"22","author":"A Figueroa","year":"2015","journal-title":"Menopause"},{"issue":"2","key":"pone.0344674.ref060","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1097\/GME.0b013e318294528c","article-title":"Whole-body vibration exercise training reduces arterial stiffness in postmenopausal women with prehypertension and hypertension","volume":"21","author":"A Figueroa","year":"2014","journal-title":"Menopause"},{"issue":"5","key":"pone.0344674.ref061","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1089\/met.2014.0135","article-title":"Circuit resistance training attenuates acute exertion-induced reductions in arterial function but not inflammation in obese women","volume":"13","author":"NC Franklin","year":"2015","journal-title":"Metab Syndr Relat Disord"},{"issue":"4","key":"pone.0344674.ref062","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1053\/j.ajkd.2015.06.016","article-title":"Aerobic or resistance training and pulse wave velocity in kidney transplant recipients: a 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