{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T20:48:06Z","timestamp":1791492486846,"version":"4.3.4"},"reference-count":52,"publisher":"Journal of Sports Science and Medicine","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["jsportscimed"],"abstract":"<jats:p>We investigated the effects of 8-week aquatic moderate-intensity continuous training (aMICT) and aquatic high-intensity interval training (aHIIT) on body composition, aerobic fitness, arterial stiffness, and endothelial function in overweight and obese young adults (OOYA). Sixty-one OOYA were randomly assigned to aHIIT, aMICT, or Control group. aHIIT group underwent twelve 30-second exercise bouts with the intensity of 85-95% HRmax, with a 60-second rest between each bout. aMICT group underwent an uninterrupted exercise with the intensity of 70-75% HRmax for 30 minutes. Endothelial function was assessed using brachial artery flow-mediated dilation (FMD) and arterial stiffness was evaluated through pulse wave velocity (PWV) and ankle-brachial index (ABI). Results revealed that aHIIT but not aMICT decreased ABI and increased FMD and skeletal muscle mass, whereas only aMICT decreased resting heart rate. A positive correlation was found between the change in weight with the change in FMD (r = 0.527, p = 0.020) after aHIIT. Following subgroup analysis, a positive correlation between change in weight and change in FMD was also found in participants with increased skeletal muscle mass in aHIIT group (r = 0.665, p = 0.002). Moreover, the change in VO2max was positively correlated with the change in FMD (r = 0.568, p &lt; 0.001). In conclusion, both aHIIT and aMICT can raise aerobic capacity among OOYA. Importantly, aHIIT offers a time-efficient option to improve vascular function in OOYA, whereas aMICT may be preferable when the primary goal is to lower resting heart rate.<\/jats:p>","DOI":"10.52082\/jssm.2025.666","type":"journal-article","created":{"date-parts":[[2025,8,17]],"date-time":"2025-08-17T06:57:58Z","timestamp":1755413878000},"page":"666-675","source":"Crossref","is-referenced-by-count":4,"title":["Aquatic High-Intensity Interval Training Improves Vascular Function, Whereas Aquatic Moderate-Intensity Continuous Training Lowers Resting Heart Rate in Overweight and Obese Young Adults: A Randomized Controlled Trial"],"prefix":"10.52082","author":[{"given":"Zhendong","family":"Yu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Songxing","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianwei","family":"Peng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qihong","family":"Fan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Leng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongdong","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinghui","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haijie","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junhao","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"29163","published-online":{"date-parts":[[2025,9,1]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Aboyans V., Criqui M.H., Abraham P., Allison M.A., Creager M.A., Diehm C., Fowkes F.G.R., Hiatt W.R., J\u00f6nsson B., Lacroix P., Marin B., McDermott M.M., Norgren L., Pande R.L., Preux P.-M., Stoffers H.E., Treat-Jacobson D. (2012) Measurement and interpretation of the ankle-brachial index. Circulation 126, 2890-2909.  Crossref","DOI":"10.1161\/cir.0b013e318276fbcb"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Adams V., Reich B., Uhlemann M., Niebauer J. (2017) Molecular effects of exercise training in patients with cardiovascular disease: Focus on skeletal muscle, endothelium, and myocardium. American Journal of Physiology - Heart and Circulatory Physiology 313, 72-88.  Crossref","DOI":"10.1152\/ajpheart.00470.2016"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Andersen L.B. (1995) A maximal cycle exercise protocol to predict maximal oxygen uptake. Scandinavian Journal of Medicine & Science in Sports 5, 143-146.  Crossref","DOI":"10.1111\/j.1600-0838.1995.tb00027.x"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Atkinson G., Reilly T. (1996) Circadian variation in sports performance. Sports Medicine 21, 292-312.  Crossref","DOI":"10.2165\/00007256-199621040-00005"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Batrakoulis A., Jamurtas A.Z., Metsios G.S., Perivoliotis K., Liguori G., Feito Y., Riebe D., Thompson W.R., Angelopoulos T.J., Krustrup P., Mohr M., Draganidis D., Poulios A., Fatouros I.G. (2022) Comparative efficacy of 5 exercise types on cardiometabolic health in overweight and obese adults: A systematic review and network meta-analysis of 81 randomized controlled trials. Circulation: Cardiovascular Quality and Outcomes 15.  Crossref","DOI":"10.1161\/circoutcomes.121.008243"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Ben Cheikh I., Marzouki H., Selmi O., Cherni B., Bouray S., Bouhlel E., Bouassida A., Knechtle B., Chen Y.S. (2025) Effect of water-based aerobic training on anthropometric, biochemical, cardiovascular, and explosive strength parameters in young overweight and obese women: A randomized controlled trial. PeerJ 13, e19020.  Crossref","DOI":"10.7717\/peerj.19020"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Bessesen D.H., Van Gaal L.F. (2018) Progress and challenges in anti-obesity pharmacotherapy. Lancet Diabetes & Endocrinology 6, 237-248.  Crossref","DOI":"10.1016\/s2213-8587(17)30236-x"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Bishop D. (2003) Warm up II: Performance changes following active warm up and how to structure the warm up. Sports Medicine 33, 483-498.  Crossref","DOI":"10.2165\/00007256-200333070-00002"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Bush N.C., Chandler-Laney P.C., Rouse D.J., Granger W.M., Oster R.A., Gower B.A. (2011) Higher maternal gestational glucose concentration is associated with lower offspring insulin sensitivity and altered \u03b2-cell function. The Journal of Clinical Endocrinology & Metabolism 96, 803-809.  Crossref","DOI":"10.1210\/jc.2010-2902"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Caballero A.E. (2003) Endothelial dysfunction in obesity and insulin resistance: A road to diabetes and heart disease. Obesity Research 11, 1278-1289.  Crossref","DOI":"10.1038\/oby.2003.174"},{"key":"ref10","unstructured":"Journal of Sports Science and Medicine Collaboration N.C.D.R.F. (2024) Worldwide trends in underweight and obesity from 1990 to 2022: A pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults. The Lancet 403, 1027-1050.  Crossref"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Journal of Sports Science and Medicine Conover W.J., Iman R.L. (1981) Rank transformations as a bridge between parametric and nonparametric statistics. The American Statistician 35, 124-129.  Crossref","DOI":"10.1080\/00031305.1981.10479327"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Cooney M.T., Vartiainen E., Laakitainen T., Juolevi A., Dudina A., Graham I.M. (2010) Elevated resting heart rate is an independent risk factor for cardiovascular disease in healthy men and women. American Heart Journal 159, 612-619.  Crossref","DOI":"10.1016\/j.ahj.2009.12.029"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine de Haan M., van der Zwaard S., Schreven S., Beek P.J., Jaspers R.T. (2024) Determining V\u0307O(2max) in competitive swimmers: Comparing the validity and reliability of cycling, arm cranking, ergometer swimming, and tethered swimming. Journal of Science and Medicine in Sport 27, 499-506.  Crossref","DOI":"10.1016\/j.jsams.2024.03.015"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine de Oliveira G.H., Boutouyrie P., Sim\u00f5es C.F., Locatelli J.C., Mendes V.H.S., Reck H.B., Costa C.E., Okawa R.T.P., Lopes W.A. (2020) The impact of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on arterial stiffness and blood pressure in young obese women: A randomized controlled trial. Hypertension Research 43, 1315-1318.  Crossref","DOI":"10.1038\/s41440-020-0477-2"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Epstein M. (1976) Cardiovascular and renal effects of head-out water immersion in man: Application of the model in the assessment of volume homeostasis. Circulation Research 39.  Crossref","DOI":"10.1161\/01.res.39.5.619"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Florian J.P., Simmons E.E., Chon K.H., Faes L., Shykoff B.E. (2013) Cardiovascular and autonomic responses to physiological stressors before and after six hours of water immersion. Journal of Applied Physiology 115, 1275-1289.  Crossref","DOI":"10.1152\/japplphysiol.00466.2013"},{"key":"ref17","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Giugliano G., Sannino A., Brevetti L., Perrino C., Schiattarella G.G., Franzone A., Serino F., Ferrone M., Scudiero F., Carbone A., De Paulis M., Izzo R., Amato B., Trimarco B., Esposito G. (2012) Ankle\/brachial index to everyone. BMC Surgery 12.  Crossref","DOI":"10.1186\/1471-2482-12-s1-s18"},{"key":"ref18","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Green D.J., Maiorana A., O'Driscoll G., Taylor R. (2004) Effect of exercise training on endothelium-derived nitric oxide function in humans. Journal of Physiology 561, 1-25.  Crossref","DOI":"10.1113\/jphysiol.2004.068197"},{"key":"ref19","doi-asserted-by":"crossref","unstructured":"Journal of Sports Science and Medicine Gutierrez E., Flammer A.J., Lerman L.O., Elizaga J., Lerman A., Fernandez-Aviles F. (2013) Endothelial dysfunction over the course of coronary artery disease. European Heart Journal 34, 3175-3181.  Crossref","DOI":"10.1093\/eurheartj\/eht351"},{"key":"ref20","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Huang J., Lai Q., Wang D., Yin H., Liao J., Wang S., Xu F., Hou X., Hu M. (2019) Effects of exercise training with dietary restriction on arterial stiffness, central hemodynamic parameters and cardiac autonomic function in obese adolescents. Diabetes, Metabolic Syndrome and Obesity 12, 2157-2163.  Crossref","DOI":"10.2147\/dmso.s223514"},{"key":"ref21","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Huang J., Wang S., Xu F., Wang D., Yin H., Lai Q., Liao J., Hou X., Hu M. (2017) Exercise training with dietary restriction enhances circulating irisin level associated with increasing endothelial progenitor cell number in obese adults: An intervention study. PeerJ 5, e3669.  Crossref","DOI":"10.7717\/peerj.3669"},{"key":"ref22","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Jefferson M.E., Nicklas B.J., Chmelo E.A., Crotts C.I., Shaltout H.A., Diz D.I., Marsh A.P., Brinkley T.E. (2016) Effects of resistance training with and without caloric restriction on arterial stiffness in overweight and obese older adults. American Journal of Hypertension 29, 494-500.  Crossref","DOI":"10.1093\/ajh\/hpv139"},{"key":"ref23","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Joris P.J., Zeegers M.P., Mensink R.P. (2015) Weight loss improves fasting flow-mediated vasodilation in adults: A meta-analysis of intervention studies. Atherosclerosis 239, 21-30.  Crossref","DOI":"10.1016\/j.atherosclerosis.2014.12.056"},{"key":"ref24","doi-asserted-by":"crossref","unstructured":"Journal of Sports Science and Medicine Kanitz A.C., Delevatti R.S., Reichert T., Liedtke G.V., Ferrari R., Almada B.P., Pinto S.S., Alberton C.L., Kruel L.F. (2015) Effects of two deep water training programs on cardiorespiratory and muscular strength responses in older adults. Experimental Gerontology 64, 55-61.  Crossref","DOI":"10.1016\/j.exger.2015.02.013"},{"key":"ref25","doi-asserted-by":"crossref","unstructured":"Journal of Sports Science and Medicine Kyte K.H., Lunde C., Hisdal J. (2023) Post-exercise ankle-brachial index is reduced in healthy, young individuals at a level indicating peripheral artery disease. Clinics and Practice 13, 529-536.  Crossref","DOI":"10.3390\/clinpract13020049"},{"key":"ref26","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Lahart I.M., Metsios G.S. (2017) Chronic physiological effects of swim training interventions in non-elite swimmers: A systematic review and meta-analysis. Sports Medicine 48, 337-359.  Crossref","DOI":"10.1007\/s40279-017-0805-0"},{"key":"ref27","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Laurent S., Caviezel B., Beck L., Girerd X., Billaud E., Boutouyrie P., Hoeks A., Safar M. (1994) Carotid artery distensibility and distending pressure in hypertensive humans. Hypertension 23, 878-883.  Crossref","DOI":"10.1161\/01.hyp.23.6.878"},{"key":"ref28","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Laurent S., Cockcroft J., Van Bortel L., Boutouyrie P., Giannattasio C., Hayoz D., Pannier B., Vlachopoulos C., Wilkinson I., Struijker-Boudier H. (2006) Expert consensus document on arterial stiffness: Methodological issues and clinical applications. European Heart Journal 27, 2588-2605.  Crossref","DOI":"10.1093\/eurheartj\/ehl254"},{"key":"ref29","doi-asserted-by":"crossref","unstructured":"Journal of Sports Science and Medicine Lekakis J., Abraham P., Balbarini A., Blann A., Boulanger C.M., Cockcroft J., Cosentino F., Deanfield J., Gallino A., Ikonomidis I., Kremastinos D., Landmesser U., Protogerou A., Stefanadis C., Tousoulis D., Vassalli G., Vink H., Werner N., Wilkinson I., Vlachopoulos C. (2011) Methods for evaluating endothelial function: A position statement from the European Society of Cardiology Working Group on Peripheral Circulation. European Journal of Cardiovascular Prevention & Rehabilitation 18, 775-789.  Crossref","DOI":"10.1177\/1741826711398179"},{"key":"ref30","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Luo P., Wu R., Gao W., Yan W., Wang R., Ye Y. (2024) Effects of high-intensity interval exercise on arterial stiffness in individuals at risk for cardiovascular disease: A meta-analysis. Frontiers in Cardiovascular Medicine 11.  Crossref","DOI":"10.3389\/fcvm.2024.1376861"},{"key":"ref31","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine McDaniel, B.B., Naquin, M.R., Sirikul, B. and Kraemer, R.R. (2020) Five weeks of aquatic-calisthenic high intensity interval training improves cardiorespiratory fitness and body composition in sedentary young adults. Journal of Sports Science and Medicine 19, 187-194.  Pubmed","DOI":"10.1249\/01.mss.0000563036.95297.1d"},{"key":"ref32","unstructured":"Journal of Sports Science and Medicine Medicine, A.C.o.S. (2021) ACSM\u2019s Guidelines for Exercise Testing and Prescription (11th ed.). Philadelphia."},{"key":"ref33","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Mezhal F., Oulhaj A., Abdulle A., AlJunaibi A., Alnaeemi A., Ahmad A., Leinberger-Jabari A., Al Dhaheri A.S., AlZaabi E., Al-Maskari F., Alanouti F., Alameri F., Alsafar H., Alblooshi H., Alkaabi J., Wareth L.A., Aljaber M., Kazim M., Weitzman M., Al-Houqani M., Ali M.H., Tuzcu E.M., Oumeziane N., El-Shahawy O., Al-Rifai R.H., Sherman S., Shah S.M., Alzaabi T., Loney T., Almahmeed W., Idaghdour Y., Ahmed L.A., Ali R. (2023) High prevalence of cardiometabolic risk factors amongst young adults in the United Arab Emirates: The UAE Healthy Future Study. BMC Cardiovascular Disorders 23.  Crossref","DOI":"10.1186\/s12872-023-03165-3"},{"key":"ref34","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Montero D. (2015) The association of cardiorespiratory fitness with endothelial or smooth muscle vasodilator function. European Journal of Preventive Cardiology 22, 1200-1211.  Crossref","DOI":"10.1177\/2047487314553780"},{"key":"ref35","doi-asserted-by":"crossref","unstructured":"Journal of Sports Science and Medicine Nagle E.F., Sanders M.E., Franklin B.A. (2017) Aquatic high intensity interval training for cardiometabolic health: Benefits and training design. American Journal of Lifestyle Medicine 11, 64-76.  Crossref","DOI":"10.1177\/1559827615583640"},{"key":"ref36","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Palmieri E.A., Palmieri V., Innelli P., Arezzi E., Ferrara L.A., Celentano A., Fazio S. (2005) Aerobic exercise performance correlates with post-ischemic flow-mediated dilation of the brachial artery in young healthy men. European Journal of Applied Physiology 94, 113-117.  Crossref","DOI":"10.1007\/s00421-004-1285-0"},{"key":"ref37","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Perini R., Milesi S., Biancardi L., Pendergast D.R., Veicsteinas A. (1998) Heart rate variability in exercising humans: Effect of water immersion. European Journal of Applied Physiology and Occupational Physiology 77, 326-332.  Crossref","DOI":"10.1007\/s004210050341"},{"key":"ref38","doi-asserted-by":"crossref","unstructured":"Journal of Sports Science and Medicine Quade D. (1967) Rank analysis of covariance. Journal of the American Statistical Association 62.  Crossref","DOI":"10.2307\/2283769"},{"key":"ref39","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Ramos J.S., Dalleck L.C., Tjonna A.E., Beetham K.S., Coombes J.S. (2015) The impact of high-intensity interval training versus moderate-intensity continuous training on vascular function: A systematic review and meta-analysis. Sports Medicine 45, 679-692.  Crossref","DOI":"10.1007\/s40279-015-0321-z"},{"key":"ref40","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Ravnholt T., Tybirk J., J\u00f8rgensen N.R., Bangsbo J. (2018) High-intensity intermittent \u201c5-10-15\u201d running reduces body fat, and increases lean body mass, bone mineral density, and performance in untrained subjects. European Journal of Applied Physiology 118, 1221-1230.  Crossref","DOI":"10.1007\/s00421-018-3851-x"},{"key":"ref41","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Regensteiner J.G., Bauer T.A., Reusch J.E. (2005) Rosiglitazone improves exercise capacity in individuals with type 2 diabetes. Diabetes Care 28, 2877-2883.  Crossref","DOI":"10.2337\/diacare.28.12.2877"},{"key":"ref42","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Roberts A.C., Porter K.E. (2013) Cellular and molecular mechanisms of endothelial dysfunction in diabetes. Diabetes & Vascular Disease Research 10, 472-482.  Crossref","DOI":"10.1177\/1479164113500680"},{"key":"ref43","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Sawyer B.J., Tucker W.J., Bhammar D.M., Ryder J.R., Sweazea K.L., Gaesser G.A. (2016) Effects of high-intensity interval training and moderate-intensity continuous training on endothelial function and cardiometabolic risk markers in obese adults. Journal of Applied Physiology 121, 279-288.  Crossref","DOI":"10.1152\/japplphysiol.00024.2016"},{"key":"ref44","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Schjerve I.E., Tyldum G.A., Tjonna A.E., Stolen T., Loennechen J.P., Hansen H.E., Haram P.M., Heinrich G., Bye A., Najjar S.M., Smith G.L., Slordahl S.A., Kemi O.J., Wisloff U. (2008) Both aerobic endurance and strength training programmes improve cardiovascular health in obese adults. Clinical Science 115, 283-293.  Crossref","DOI":"10.1042\/cs20070332"},{"key":"ref45","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Signorelli S.S., Fiore V., Catanzaro S., Simili M., Torrisi B., Anzaldi M. (2011) Prevalence of high ankle-brachial index (ABI) in general population of Southern Italy, risk factor profiles and systemic cardiovascular co-morbidity: An epidemiological study. Archives of Gerontology and Geriatrics 53, 55-59.  Crossref","DOI":"10.1016\/j.archger.2010.05.020"},{"key":"ref46","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Song P., Rudan D., Zhu Y., Fowkes F.J.I., Rahimi K., Fowkes F.G.R., Rudan I. (2019) Global, regional, and national prevalence and risk factors for peripheral artery disease in 2015: An updated systematic review and analysis. Lancet Global Health 7, 1020-1030.  Crossref","DOI":"10.1016\/s2214-109x(19)30255-4"},{"key":"ref47","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Sugawara J., Tomoto T., Tanaka H. (2019) Heart-to-brachium pulse wave velocity as a measure of proximal aortic stiffness: MRI and longitudinal studies. American Journal of Hypertension 32, 146-154.  Crossref","DOI":"10.1093\/ajh\/hpy166"},{"key":"ref48","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Tang S., Huang W., Wang S., Wu Y., Guo L., Huang J., Hu M. (2022) Effects of aquatic high-intensity interval training and moderate-intensity continuous training on central hemodynamic parameters, endothelial function and aerobic fitness in inactive adults. Journal of Exercise Science & Fitness 20, 256-262.  Crossref","DOI":"10.1016\/j.jesf.2022.04.004"},{"key":"ref49","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Volpe M., Gallo G. (2023) Obesity and cardiovascular disease: An executive document on pathophysiological and clinical links promoted by the Italian Society of Cardiovascular Prevention (SIPREC). Frontiers in Cardiovascular Medicine 10.  Crossref","DOI":"10.3389\/fcvm.2023.1136340"},{"key":"ref50","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Weenink R.P., Wingelaar T.T. (2021) The circulatory effects of increased hydrostatic pressure due to immersion and submersion. Frontiers in Physiology 12, 699493.  Crossref","DOI":"10.3389\/fphys.2021.699493"},{"key":"ref51","doi-asserted-by":"publisher","unstructured":"Journal of Sports Science and Medicine Zhu H., Jin J., Zhao G. (2023) The effects of water-based exercise on body composition: A systematic review and meta-analysis. Complementary Therapies in Clinical Practice 52, 101766.  Crossref","DOI":"10.1016\/j.ctcp.2023.101766"}],"container-title":["Journal of Sports Science and Medicine"],"original-title":[],"language":"en","deposited":{"date-parts":[[2025,8,17]],"date-time":"2025-08-17T06:58:02Z","timestamp":1755413882000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jssm.org\/jssm-24-666.xml-Fulltext"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,1]]},"references-count":52,"URL":"https:\/\/doi.org\/10.52082\/jssm.2025.666","archive":["Internet Archive"],"relation":{},"ISSN":["1303-2968"],"issn-type":[{"value":"1303-2968","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,1]]}}}