Research extensively investigates how physical activity impacts long-term arterial remodeling, including changes in arterial wall thickness, diameter, and the wall-to-lumen ratio.[1], [2]. Both cross-sectional [3], [4], [5] and longitudinal studies [2], [4], [5] detected physical activity-induced alterations in arterial anatomy. Blood flow and shear stress patterns vary with exercise type [6], potentially leading to chronic vascular remodeling that reduces exercise-specific shear stress. [6]

Studies have shown significant differences in the femoral [1], [3], [7] and brachial arteries [4], [8] of endurance and strength athletes compared to sedentary individuals, while central vessels like the aorta [1] or carotid arteries [5], [7] exhibit no significant changes. Peripheral arteries tend to be stiffer due to variations in structural properties such as collagen and elastin distribution [9], indicating that arterial remodeling from chronic physical training may vary across different vascular beds, particularly in response to exercise-induced blood flow patterns and shear stress. However, data regarding the effect of exercise on arterial function in active individuals versus controls remain inconclusive. Some studies suggest improved arterial function, measured by flow-mediated dilation (FMD), in physically active participants compared to controls [8], while others propose an “athlete's paradox,” where function does not seem to improve, possibly due to structural enlargement of arteries affecting FMD calculations [10].

A research gap is the direct comparison of various training modalities which remains poorly understood [11].

Our study aimed to evaluate exercise training's influence on brachial artery morpho-functional parameters by comparing different sporting categories (skills, power, endurance, and mixed) [12].