Cardiovascular Risk Factor Changes Associated with Six-Year Circuit Training in Older Adults: A Retrospective Cohort Analysis

Marcelo Pereira de Lima¹Renata Miyabara^1,2Lujain Khalaf³Shady Salah Bagady³Saed Fawaz Raddawi³Jose Antonio Silva Jr⁴Luciana Aparecida Campos^1*Ovidiu Constantin Baltatu^3,5*

• ¹Anhembi Morumbi University, Center of Innovation, Technology, and Education (CITE), Sao Jose dos campos, Brazil
• ²Centro Universitario Uninovafapi, Brasilar, Brazil
• ³Alfaisal University College of Medicine, Riyadh, Saudi Arabia
• ⁴Universidade Nove de Julho, São Paulo, Brazil
• ⁵Center of Innovation, Technology and Education (CITE), Anhembi Morumbi University, São Paulo, São Paulo, Brazil

Background: Physical exercise can significantly impact chronic disease prevention and health promotion in older adults. This retrospective cohort study evaluated the association between participation in a multidisciplinary physical exercise program and cardiovascular health outcomes in older adults over six years. Methods: The Active Life circuit resistance training program incorporated aerobic, strength, balance, and flexibility exercises delivered in a community-based setting. While the Active Life Program was prospectively planned and implemented as a 6-year community-based intervention, the present study is a retrospective analysis of participants selected based on adherence (≥75% attendance) and availability of complete data from a digital platform. Thirty participants (n=30; mean age 70.2 ± 5.4 years) completed the program, with 30 sedentary controls (n=30) included for comparison. Eligibility criteria included age ≥60, presence of chronic cardiovascular risk factors, and ability to engage in moderate physical exercise. A concurrent sedentary control group (attendance <25%) was selected from the same eligible population. Cardiovascular risk factors were assessed at 6-month intervals. Results: Compared to the sedentary group, the Active Life group demonstrated significantly lower systolic arterial pressure (p = 0.0009, η² = 11.53%), with an average between-group difference of 10.5 ± 2.4 mmHg over the 1.5 to 6.0-year period. A significant reduction in the triglyceride-to-HDL-C ratio was observed starting at 2.5 years (p = 0.0146, η² = 7.09%). Additionally, the Active Life group exhibited lower triglyceride levels (p = 0.0134, η² = 5.73%; average difference: 33.9 ± 5.8 mg/dL) and fasting glucose levels (p = 0.0163, η² = 6.23%; average difference: 16.1 ± 4.9 mg/dL) over the 3.0 to 6.0-year period compared to controls. No significant differences were observed in diastolic blood pressure, total cholesterol, LDL-C, or HDL-C. Conclusions: This retrospective analysis suggests that sustained participation in a circuit resistance training program may be associated with favorable cardiovascular and metabolic profiles in older adults. However, given the non-randomized design, small sample size, and potential selection bias, these findings should be considered preliminary and exploratory. Future randomized controlled trials are needed to confirm these associations and establish causality.