Cycling effect on EPC to risk of cardiovascular disease in geriatry: systematic review


  • Farida Murtiani RSPI Prof Dr Sulianti Saroso
  • Upik Rahmi Program Studi DIII Keperawatan, Fakultas Pendidikan Olahraga dan Kesehatan, Universitas Pendidikan Indonesia
  • Septian Andriyani Program Studi DIII Keperawatan, Fakultas Pendidikan Olahraga dan Kesehatan, Universitas Pendidikan Indonesia
  • Suci Tuty Putri Program Studi DIII Keperawatan, Fakultas Pendidikan Olahraga dan Kesehatan, Universitas Pendidikan Indonesia
  • Lisna Annisa Fitriana Program Studi DIII Keperawatan, Fakultas Pendidikan Olahraga dan Kesehatan, Universitas Pendidikan Indonesia



Cycling, Endothelial Progenitor Cell, Physical Activity, Cardiovascular


This systematic review aims to review published articles on the effects of physical activity (PA) cycling on biomarkers of endothelial cell function on the risk of cardiovascular disease. Studies involving angiogenic factors were searched in the Medline and Cochrane libraries. Native human studies over 2 weeks of PA intervention were included. Study quality was assessed according to the GRADE evidence system. Results: five complete articles according to the inclusion criteria. Cycling increases angiogenic, endothelial progenitor cells (EPC) and decreased VEGF. The effect of PA on this factor appears to depend on the type and duration of exercise intervention and patient factors, such as the presence of ischemia. As presented in this review, there is strong evidence that cycling physical activity positively affects endothelial cell function and determines the risk of carciovascular disease.


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Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2095–128.

Nag T, Ghosh A. Cardiovascular disease risk factors in Asian Indian population : A systematic review. J Cardiovasc Dis Res [Internet]. 2014;4(4):222–8. Available from:

Badan Penelitian dan Pengembangan Kesehatan. Laporan Hasil Riset Kesehatan Dasar (Riskesdas) Indonesia tahun 2018 [Internet]. Riset Kesehatan Dasar 2018. 2019. p. 182–3. Available from:

Brien MWO, Johns JA, Petterson JL, Mekary S, Kimmerly DS. The impact of age and sex on popliteal artery endothelial-dependent vasodilator and vasoconstrictor function. Exp Gerontol [Internet]. 2021;145(November 2020):111221. Available from:

Black MA, Cable NT, Thijssen DHJ, Green DJ. Impact of age, sex, and exercise on brachial artery flow-mediated dilatation. Am J Physiol - Hear Circ Physiol. 2013;297(3):1109–17.

Fitri M, Rahmi U, Pitriani P, Sulastri A. Efektivitas senam vitalisasi otak terhadap kebugaran jasmani pada lansia demensia. J Sport J Penelit Pembelajaran [Internet]. 2020;6(2):364–74. Available from:

Wen W, Luo R, Tang X, Tang L, Huang HX, Wen X, et al. Age-related progression of arterial stiffness and its elevated positive association with blood pressure in healthy people. Atherosclerosis [Internet]. 2015;238(1):147–52. Available from:

Xia WH, Yang Z, Xu SY, Chen L, Zhang XY, Li J, et al. Age-related decline in reendothelialization capacity of human endothelial progenitor cells is restored by shear stress. Hypertension. 2012;59(6):1225–31.

Ross M, Ingram L, Taylor G, Malone E, Simpson RJ, West D, et al. Older men display elevated levels of senescence-associated exercise-responsive CD28null angiogenic T cells compared with younger men. Physiol Rep. 2018;6(12):1–11.

Lu CL, Leu JG, Liu WC, Zheng CM, Lin YF, Shyu JF, et al. Endothelial progenitor cells predict long-term mortality in hemodialysis patients. Int J Med Sci. 2016;13(3):240–7.

Salybekov AA, Kobayashi S, Asahara T. Characterization of Endothelial Progenitor Cell : Past , Present , and Future. 2022;

Masuda H, Tanaka R, Fujimura S, Ishikawa M, Akimaru H, Shizuno T, et al. Vasculogenic Conditioning of Peripheral Blood Mononuclear Cells. 2014;1–29.

Hur J, Yang HM, Yoon CH, Lee CS, Park KW, Kim JH, et al. Identification of a novel role of T cells in postnatal vasculogenesis: Characterization of endothelial progenitor cell colonies. Circulation. 2017;116(15):1671–82.

Rouhl RPW, Mertens AECS, Van Oostenbrugge RJ, Damoiseaux JGMC, Debrus-Palmans LL, Henskens LHG, et al. Angiogenic T-cells and putative endothelial progenitor cells in hypertension-related cerebral small vessel disease. Stroke. 2012;43(1):256–8.

Holtermann A, Marott JL, Gyntelberg F, Søgaard K, Mortensen OS, Prescott E, et al. Self-reported cardiorespiratory fitness: prediction and classification of risk of cardiovascular disease mortality and longevity--a prospective investigation in the Copenhagen City Heart Study. J Am Heart Assoc. 2015;4(1):e001495.

Ross MD, Wekesa AL, Phelan JP, Harrison M. Resistance exercise increases endothelial progenitor cells and angiogenic factors. Med Sci Sports Exerc. 2014;46(1):16–23.

Pietrelli A, Lopez-Costa J, Goñi R, Brusco A, Basso N. Aerobic exercise prevents age-dependent cognitive decline and reduces anxiety-related behaviors in middle-aged and old rats. Neuroscience [Internet]. 2012;202:252–66. Available from:

Black MA, Green DJ, Cable NT. Exercise prevents age-related decline in nitric-oxide-mediated vasodilator function in cutaneous microvessels. J Physiol. 2018;586(14):3511–24.

Delavar H, Nogueira L, Wagner PD, Hogan MC, Metzger D, Breen EC. Skeletal myofiber VEGF is essential for the exercise training response in adult mice. Am J Physiol - Regul Integr Comp Physiol. 2014;306(8):586–95.

Langer G, Meerpohl JJ, Perleth M, Gartlehner G, Kaminski-hartenthaler A, Schünemann H. GRADE-Evidenzprofile und. 2012;

Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J, et al. GRADE guidelines: 1. Introduction - GRADE evidence profiles and summary of findings tables. J Clin Epidemiol. 2012;64(4):383–94.

Van Craenenbroeck EM, Frederix G, Pattyn N, Beckers P, Van Craenenbroeck AH, Gevaert A, et al. Effects of aerobic interval training and continuous training on cellular markers of endothelial integrity in coronary artery disease: a SAINTEX-CAD substudy. Am J Physiol Heart Circ Physiol. 2015 Dec;309(11):H1876-82.

Heart IJC, Kourek C, Alshamari M, Mitsiou G, Psarra K, Delis D, et al. The acute and long-term effects of a cardiac rehabilitation program on endothelial progenitor cells in chronic heart failure patients : Comparing two different exercise training protocols. IJC Hear Vasc [Internet]. 2021;32:100702. Available from:

Lavini-ramos C, Schettert IT. Exercise training restores the endothelial progenitor cells number and function in hypertension: implications for angiogenesis. 2012;2133–43.

Craenenbroeck EM Van, Frederix G, Pattyn N, Beckers P, Craenenbroeck XAH Van, Gevaert A, et al. Latihan Penyakit Kardiovaskular : Mekanisme dan Hasil Pengaruh pelatihan interval aerobik dan pelatihan berkelanjutan pada penanda seluler integritas endotel pada penyakit arteri koroner : substudy SAINTEX-CAD. 2015;1876–82.

Ribeiro. Effects of Exercise Training on Endothelial Progenitor Cells in Cardiovascular Disease. 2013;92(11).

Burger D, Touyz RM. Cellular biomarkers of endothelial health : microparticles , endothelial progenitor cells , and circulating endothelial cells. J Am Soc Hypertens [Internet]. 2012;6(2):85–99. Available from:

Madonna R, Caterina R De. Circulating endothelial progenitor cells : Do they live up to their name ? Vascul Pharmacol [Internet]. 2015;8–11. Available from:

Cesari F, Sofi F, Corsani I, Pucci N, Caporale R, Abbate R, et al. [22] Effect of a Personalized Physical Activity Programme on Weight Reduction and Endothelial Progenitor Cells in Overweight Subjects. Nutr Metab Cardiovasc Dis [Internet]. 2019;19:S6. Available from:

Hill JM, Zalos G, Halcox JPJ, Schenke WH, Waclawiw MA, Quyyumi AA, et al. Circulating Endothelial Progenitor Cells, Vascular Function, and Cardiovascular Risk. Obstet Gynecol Surv. 2013;58(7):467–8.

Sian P, Lee S, Poh KK. Endothelial progenitor cells in cardiovascular diseases. 2014;6(3):355–66.

Konukoglu D, Uzun H. Endothelial Dysfunction and Hypertension. 2016;

Liao JK, Liao JK. Linking endothelial dysfunction with endothelial cell activation Linking endothelial dysfunction with endothelial cell activation. 2013;123(2):540–1.

Endemann DH, Schiffrin EL. Endothelial dysfunction. J Am Soc Nephrol. 2014;15(8):1983–92.

Haberzettl P, Conklin DJ, O’Toole TE. Endothelial Progenitor Cells: Properties, Function, and Response to Toxicological Stimuli [Internet]. Third Edit. Vols. 12–15, Comprehensive Toxicology: Third Edition. Elsevier; 2018. 130–182 p. Available from:

Drexler H, Hornig B. Endothelial dysfunction in human disease. J Mol Cell Cardiol. 2019;31(1):51–60.

Fadini GP, Albiero M, De Kreutzenberg SV, Boscaro E, Cappellari R, Marescotti M, et al. Diabetes impairs stem cell and proangiogenic cell mobilization in humans. Diabetes Care. 2013;36(4):943–9.

Sugawara J, Mitsui-Saito M, Hoshiai T, Hayashi C, Kimura Y, Okamura K. Circulating endothelial progenitor cells during human pregnancy. J Clin Endocrinol Metab. 2015;90(3):1845–8.







How to Cite

Murtiani F, Rahmi U, Andriyani S, Tuty Putri S, Annisa Fitriana L. Cycling effect on EPC to risk of cardiovascular disease in geriatry: systematic review. J Keskom [Internet]. 2023 Jul. 26 [cited 2024 Apr. 22];9(2):213-20. Available from: