The Impact of Exercise Training in a Hypobaric/Normobaric Hypoxic Environment on Cardiometabolic Health in Adults with Overweight or Obesity: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis aims to comprehensively evaluate the effects of hypoxic training (HT) versus normoxic training (NT) on cardiometabolic health parameters in overweight or obese adults. Searches were performed in PubMed, Web of Science, Embase, Scopus, and the Cochrane Library. A meta-analysis was performed using Stata 18 and RevMan 5.4 software. Seventeen randomized controlled studies involving 517 participants were included. HT significantly improved cardiorespiratory fitness (CRF) and reduced systolic blood pressure (SBP) and diastolic blood pressure (DBP). Compared with NT, HT demonstrated a significant difference in CRF, but no significant differences were observed in SBP and DBP. The subgroup analysis of CRF revealed that HT significantly outperformed NT in six aspects: participants aged < 45 years (Hedges’ g = 0.50), an intervention duration of 8 weeks (Hedges’ g = 0.43), three sessions per week (Hedges’ g = 0.40), each session lasting < 45 min (Hedges’ g = 0.23), FiO₂ levels > 15% (Hedges’ g = 0.69), and high-load-intensity exercise (Hedges’ g = 0.57). HT demonstrated favorable effects in improving cardiometabolic health among overweight or obese adults. Compared with NT, this advantage was primarily reflected in CRF while the impacts on SBP and DBP were similar.