Qihan Lin

(1) Background: There is increasing evidence showing the health benefits of exercise on carotid atherosclerosis. However, little is known about the different exercise modes for carotid atherosclerosis. This study was designed to perform a meta-analysis of effect of different exercise modes on carotid atherosclerosis so as to provide evidence-based suggestions for the prevention and management of cardiovascular and cerebrovascular diseases. (2) Methods: Six databases were systematically searched to identify randomized trials that compared exercise to a non-exercise intervention in patient with carotid atherosclerosis. We a priori specified changes in cIMT, TC, LDL-C, and HDL-C biomarkers as outcomes. (3) Results: Thirty-four trials met the eligibility criteria, comprising 2420 participants. The main analyses showed pronounced differences on cIMT (MD = −0.06, 95%CI (−0.09, −0.04), p < 0.00001, TC (MD = −0.41, 95%CI (−0.58, −0.23), p < 0.00001), LDL-C (MD = −0.31, 95%CI (−0.43, −0.20), p < 0.00001), and HDL-C (MD = 0.11, 95%CI (0.04, 0.19), p = 0.004), which significantly reduced the risk factors of carotid atherosclerosis disease. In the different exercise modes, the effect was pronounced for aerobic exercise for all outcomes except TC; high-intensity interval exercise also showed significance for all outcomes except TC and HDL-C; aerobic exercise combined with resistance exercise did not affect any outcome except HDL-C; (4) Conclusions: Exercise has a prominent prevention and improvement effect on carotid atherosclerosis. In the perspective of exercise pattern, aerobic exercise and high-intensity intermittent exercise can improve carotid atherosclerosis; however, aerobic exercise has a more comprehensive improvement effect.