Background: Water aerobics has gained increasing attention due to its effectiveness in reducing cardiovascular risk factors. However, it remains unclear whether training program characteristics - such as intensity and duration - and participants` baseline measures, including blood pressure (BP) and lipid profile, influence the magnitude of cardiovascular adaptations to water aerobics. Aim: To examine whether changes in BP and lipid profile following a water aerobics program are associated with program intensity and duration, participant age, and baseline values of BP, lipid profile, anthropometric measures, and quality of life. Methods: Data were obtained from two randomized controlled trials involving 41 women. Twenty*one participants (65.29 ± 9.38 years) completed a 12*week program [moderate*intensity group (MIG), n=11; high*intensity group (HIG), n=10], and twenty (67.10 ± 9.14 years) completed a 24*week program (MIG, n=10; HIG, n=10). Pre* and post*intervention assessments included systolic BP, diastolic BP, triglycerides, total cholesterol, body mass index, fat mass, and quality of life. Multiple linear regression analyses were conducted to explore associations between training*related and baseline variables and cardiovascular outcomes. Results: Baseline systolic BP and total cholesterol significantly predicted post*intervention systolic BP. Post*intervention diastolic BP was associated with baseline diastolic BP, baseline total cholesterol, and program duration. Final triglyceride levels were strongly related to program intensity and baseline triglycerides, systolic BP, and diastolic BP. Post*intervention total cholesterol was associated with program intensity, as well as baseline total cholesterol and body mass index. Conclusions: The results indicate that: (i) baseline total cholesterol levels may influence BP responses to water aerobics; (ii) training intensity can play a key role in lipid profile improvements; and (iii) program duration appears to be particularly relevant for diastolic BP outcomes. These findings highlight the importance of considering both program characteristics and participants` baseline health profiles when prescribing water aerobics for cardiovascular health.
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