Regular stretching cut arterial stiffness, one bout did not

Arterial stiffness reflects how rigid the large arteries have become, and it is an established marker of cardiovascular disease risk. Pulse wave velocity, the speed at which a pressure wave travels along an artery, is the best-validated way to measure it. Most exercise research on arterial stiffness has focused on aerobic or resistance training, both of which demand equipment, time or a degree of fitness. Stretching is unusual in being low-skill, low-cost and accessible to almost anyone, so if it also influenced arterial stiffness that would matter for people who cannot easily do more demanding exercise. This review set out to pool what is known and to test which features of a stretching prescription matter.

The authors searched PubMed, Scopus, Embase and Web of Science from 1974 to 2025 for studies combining stretching with arterial stiffness or pulse wave velocity, and screened reference lists of relevant studies and prior reviews. Eligible studies enrolled adults aged 18 or over, used randomised controlled, non-randomised controlled or crossover designs, measured pulse wave velocity, and were published in English in peer-reviewed journals. From 242 studies initially identified, six acute and six longitudinal studies survived screening. Effect sizes were expressed as standardised mean differences and pooled with a three-level model using restricted maximum likelihood estimation. Moderator analyses examined frequency, intensity, time and type of stretching, plus supervision, study quality, risk of bias and the specific arterial segment measured.

A single bout of stretching produced only a small and non-significant reduction in pulse wave velocity, with an SMD of -0.22 and a 95% confidence interval from -0.62 to 0.17. Longitudinal interventions lasting 4 to 12 weeks produced a large and statistically significant reduction, SMD -1.02, 95% CI -1.79 to -0.25, p = 0.012. The only moderator to reach significance was repetition: repeating each stretch three or more times gave a substantially greater effect than fewer repetitions, with an SMD contrast of -1.46. Larger benefits were also seen with 5-7 days per week versus 3-4, sessions of at least 30 minutes, and supervised rather than unsupervised sessions, but none of these contrasts reached statistical significance.

This extends the exercise-and-vascular-health literature into a modality rarely considered cardiovascular at all, and the split between acute and longitudinal results is informative: whatever is happening seems to require repeated exposure rather than being a transient response to one session. The pooled longitudinal effect is large but rests on only six studies with a wide confidence interval, so the true size is uncertain. The authors are explicit that their conclusion is a foundation for designing a future trial to test efficacy and biological plausibility, not a demonstration that stretching lowers cardiovascular disease events. Whether reductions in pulse wave velocity from stretching translate into fewer clinical outcomes remains entirely open.

This is a reason to think of stretching as potentially more than a mobility or comfort practice, with a plausible link to vascular health when done consistently over weeks. The data point clearly towards regularity rather than any single session, and the one prescription feature that reached statistical significance was repeating each stretch several times rather than once. It is worth keeping the scale of the evidence in mind: twelve studies in total, and no direct evidence about heart attacks or strokes. Arterial stiffness is a marker, and markers do not always move clinical outcomes.