Combined training in hypoxic environments improves cardiometabolic health in older adults: a systematic review and meta-analysis of randomized controlled trials.

ABSTRACT:

Objective

The present study was designed to investigate the effects of exercise training under hypoxic versus normoxic conditions on cardiometabolic health and body composition in older adults.

Method

A systematic search was carried out in five databases, namely PubMed, Web of Science, Embase, Scopus, and the Cochrane Library. Meta-analysis, Cochrane assessment, subgroup analysis, and publication bias assessment were conducted using the Stata 18 and RevMan 5.4 analysis tools.

Results

A total of 12 randomized controlled studies were included, involving 358 participants. Subgroup analysis indicated that hypoxic training (HT) could significantly enhance the cardiorespiratory fitness (CRF) of non-healthy older adults (Hedges' g = 0.57, p < 0.05). The combination of hypoxia and combined training (CT) could significantly improve the CRF of older adults (Hedges' g = 0.88, p < 0.05) and could reduce the systolic blood pressure (SBP) (Hedges' g = -0.51, p < 0.05) and diastolic blood pressure (DBP) (Hedges' g = -0.50, p < 0.05) of older adults. Regarding body composition, no significant differences were observed in body mass (BM), body mass index (BMI), fat-free mass (FFM), and fat mass (FM) for HT.

Conclusion

Compared with exercise in a normoxic environment, CT (aerobic and resistance training) in a hypoxic environment better improves cardiometabolic health in older adults. Moreover, hypoxic training can enhance CRF in older adults with multiple comorbidities or diabetes, playing a role in preventing and improving cardiometabolic health in this population.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/view/CRD420251011076.

SUBMITTER: Chen H 

PROVIDER: S-EPMC12708552 | biostudies-literature | 2025

REPOSITORIES: biostudies-literature