Farinha (2022) The Impact of Aquatic Exercise Programs on the cardiovascular variables

Farinha (2022) The Impact of Aquatic Exercise Programs on the Intima-Media thickness of the Carotid Arteries, Hemodynamic Parameters, Lipid Profile and Chemokines of Community-Dwelling Older Persons: A Randomized Controlled Trial.


Scientific evidence has shown that physical exercise is an effective way of improving several cardiovascular disease markers. However, few studies have tested its effectiveness when performed in aquatic environments. The purpose of this study was to test the impact of different aquatic exercise programs on the intima-media thickness of carotid arteries (IMT) and hemodynamic and biochemical markers of cardiovascular diseases in community-dwelling older persons. A total of 102 participants were randomly allocated into four groups: an aerobic exercise group (AerG) (n = 25, 71.44 ± 4.84 years); an aerobic interval group (IntG) (n = 28, 72.64 ± 5.22 years); a combined group (ComG) (n = 29, 71.90 ± 5.67 years); and a control group (CG) (n = 20, 73.60 ± 5.25 years).

The AerG, IntG, and ComG participants took part in three different aquatic exercise programs for 28 weeks. The CG participants maintained their usual routines. All participants were evaluated for IMT, blood pressure, lipid profile, and MCP-1 and MIP-1α chemokines, pre- and post-intervention. Significant differences were found in the AerG for diastolic diameter (DD), in the IntG for peak systolic velocity (PSV), and in the ComG for DD and end-diastolic velocity (EDV). Regarding blood pressure, significant differences were found in AerG for systolic blood pressure (SBP) and diastolic blood pressure (DBP); in IntG for DBP; and in ComG for SBP, DBP, and heart rate (HR).

Significant differences were found in the AerG and IntG for glucose (GLU). Lower plasma levels of monocyte chemoattractant protein-1 (MCP-1) and macrophage inflammatory protein (MIP-1α) were found in the AerG and in the ComG for MCP-1 after the intervention. Aquatic physical exercise appears to
improve cardiovascular health, regardless of the type of the program adopted. Aerobic programs (combined and continuous aerobic exercises) seemed to have a more beneficial effect in reducing important cardiovascular risk markers.


Aquatic physical exercise, regardless of the type of program, seems to lead to benefits in cardiovascular variables, and this type of intervention may be a viable alternative when land-based exercise is not possible and/or desired.

In relation to the intima and average thickness of the carotid arteries, we can say that all the aquatic exercise programs studied (i.e., the continuous aerobic program, the aerobic interval program, and the combined program) can be considered as factors for hemodynamic balance and thus contribute to the reduction of stress on the arterial wall and reduce the risk of cardiovascular diseases. The combined program seems to be slightly
more beneficial, compared to the other programs due to the fact that it resulted in significant differences in a higher number of variables.

As for blood pressure, the three exercise groups showed reductions in SBP, DBP, and HR. However, the aerobic and combined exercise programs proved to be more beneficial for blood pressure and present statistically significant differences for both variables (with the same mean variation). Additionally, the combined program also showed a statistically significant reduction for HR.
Regarding the metabolic profile, our results showed that AerG and IntG are equally beneficial in reducing GLU. Regarding TC, HDL, LDL, and TG, the results did not show significant changes; however, they remain within the reference values. We concluded that aquatic physical exercise may contribute to the balance of the lipid profile.

Finally, as for chemokines, the results suggest that aquatic physical exercise, especially that with aerobic characteristics, helps prevent the development of cardiovascular diseases by contributing to the reduction in chemokines MCP-1 and MIP-1α and the subsequent infiltration of monocytes and formation of atherosclerotic plaques.

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Keywords: physical exercise; aquatic environment; hydrogymnastics; ageing; intima-media thickness of the carotid arteries; hemodynamic parameters; blood pressure; lipid profile; MDP-1α; MCP-1