BMC Cardiovasc Disord. 2026 Aug 10;26(1):1040. doi: 10.1186/s12872-026-06431-2.
ABSTRACT
PURPOSE: This study aimed to explore the effects and the underlying mechanisms of an 8-week brisk walking combined with table tennis exercise on the cardiovascular function of the middle-aged and elderly individuals.
METHODS: Forty-eight middle-aged and elderly individuals were randomly divided into the brisk walking (BW) group, table tennis (TT) group, brisk walking combined with table tennis (BT) group, and the control group. Body composition parameters were assessed using a body composition analyzer. Cardiovascular function was analyzed by pulse wave velocity (PWV), flow-mediated dilation (FMD), and heart rate variability (HRV) assessment. Plasma biomarkers levels were detected by ELISA. We also analyzed 8-week changes in a composite CVD-Z score based on established cardiovascular risk factors.
RESULTS: The BT group showed a significant increase in muscle mass (37.85 ± 7.26 to 39.01 ± 6.67). However, all three exercise modalities exhibited a significant reduction in systolic blood pressure (SBP) and central systolic blood pressure (CSBP), with a decrease of diastolic blood pressure (CDBP) observed exclusively in the BT group (75.82 ± 7.96 to 71.00 ± 6.53). The PWV analysis revealed significant decrease of the carotid-femoral Pulse Wave Velocity (cfPWV), augmentation index (AIx) and augmentation index normalized to a heart rate of 75 beats per minute (AIx@75) in BT group. While both TT and BT improved FMD (5.78 ± 0.87 to 7.30 ± 1.76 and 6.02 ± 0.95 to 8.06 ± 1.45). The HRV analysis showed BT decreased heart rate (HR), increased percent of NN intervals that differ by more than 50 ms (PNN50), standard deviation of all normal-to-normal RR intervals (SDNN), and high-frequency power (HF). An Increase in total power (TP) was detected in all the three exercise modalities. Furthermore, only BT upregulated serum levels of endothelial nitric oxide synthase (eNOS), vascular endothelial growth factor (VEGF), nicotinamide adenine dinucleotide (NAD+), and downregulated intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule-1(VCAM-1) levels. All exercise groups had reduced composite CVD-Z score after 8 weeks, with the BT group showing the largest numerical reduction.
CONCLUSION: Collectively, the BT intervention elicited the numerically greater cardiovascular function benefits, independent of weight loss, potentially via reducing arterial stiffness, enhancing parasympathetic activity, and modulating key cardiovascular biomarkers. However, the majority of these favorable numerical changes did not reach statistical significance when compared with standalone brisk walking (BW) or table tennis (TT). Meanwhile, several limitations of this trial should be noted, including its small sample size, passive control design and potential selective outcome reporting.
TRIAL REGISTRATION: This study was retrospectively registered in the Chinese Clinical Trial Registry (ChiCTR) on 28 May 2025, registration number: ChiCTR2500103378, available at: https://www.chictr.org.cn/showproj.html?proj=268481 .
PMID:42989127 | DOI:10.1186/s12872-026-06431-2
