AUTHOR=Chen Hao , Liu Peng , Cai Haibo , Deng Yidi , Liang Pu , Jiang Xin 

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

JOURNAL=Frontiers in Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1728637

DOI=10.3389/fmed.2025.1728637

ISSN=2296-858X

ABSTRACT=ObjectiveThe 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.MethodA 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.ResultsA 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.ConclusionCompared 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 registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251011076.