Inspiratory muscle strength training did not attenuate systolic blood pressure responses during peak exercise compared to sham among younger adults with obesity (interaction p≥0.62).
RCT (n=14)
Does inspiratory muscle strength training reduce peak exercise systolic blood pressure in younger adults with obesity?
Eight weeks of high-resistance inspiratory muscle strength training did not attenuate peak exercise systolic blood pressure in younger adults with obesity.
Absolute Event Rate: 0.8% vs 0.7%
p-value: p=≥0.62
Adults with obesity have exaggerated exercise systolic blood pressure (SBP) responses. Exaggerated exercise SBP is an independent predictor of cardiovascular disease and mortality. However, absolute SBP values during exercise do not account for the specific metabolic demand achieved (Formula: see textO 2 ) or the amount of metabolically active tissue (i.e., lower body lean mass, LLM) driving the cardiovascular response. Recent evidence suggests that high-resistance inspiratory muscle strength training (IMST) attenuates submaximal exercise SBP, but it is unknown whether IMST attenuates SBP indexed to LLM during peak exercise. PURPOSE: To test the hypothesis that eight weeks of IMST would reduce SBP during peak exercise in younger adults with obesity. METHODS: We randomized 14 otherwise healthy adults (254 years) with obesity (body mass index BMI 30–40 kg/m 2 ) to daily training at 75% (IMST; n=8, 6 female) or 15% (SHAM; n=6, 4 female) of their maximal inspiratory pressure for eight weeks. Pre- and post-intervention, we assessed anthropometrics, body composition and LLM via dual-energy X-ray absorptiometry, and conducted a graded cardiopulmonary exercise test on a semi-recumbent cycle ergometer. SBP responses during exercise were indexed to metabolic demands (SBPpeak minus SBPrest divided by Formula: see textO 2 peak minus Formula: see textO 2 rest) and further indexed to LLM (SBPpeak minus SBPrest divided by [Formula: see textO 2 peak minus Formula: see textO 2 rest] divided by LLM). We assessed data normality with Shapiro-Wilk tests. We compared groups using Welch’s t-tests or mixed-effects analyses. Data are reported as mean ± SD, or median IQR for non-normally distributed data. RESULTS: Training compliance (IMST: 78±15% vs. SHAM: 91±9% p=0.07) did not differ between groups. Body mass did not change during the intervention (time: p=0.71). Changes (Δ) in maximal inspiratory pressure were greater with IMST (IMST: Δ41±23 vs. SHAM: Δ15±21, cmH 2 O, p=0.04). Resting SBP, Formula: see textO 2 peak, and LLM did not differ between time points or groups (time: p≥0.27, group: p≥0.14, interaction: p≥0.30 for all). SBP responses during exercise did not differ between time points or groups when expressed in absolute terms (pre-IMST: Δ8541, post-IMST: Δ7554, pre-SHAM: Δ9144, post-SHAM: Δ7031 mmHg), indexed to Formula: see textO 2 peak (pre-IMST: Δ3.6±1.0, post-IMST: Δ3.6±1.1, pre-SHAM: Δ4.1±1.6, post-SHAM: Δ3.8±1.4 mmHg/mL O 2 /kg body mass/min), or indexed to LLM (pre-IMST: Δ0.8±0.3, post-IMST: Δ0.8±0.3, pre-SHAM: Δ0.8±0.3, post-SHAM: Δ0.7±0.3 mmHg/mL O 2 /kg LLM/min) (time: p≥0.46, group: p≥0.58, interaction: p≥0.62 for all). CONCLUSION: These preliminary data suggest that IMST does not attenuate SBP responses during peak exercise among young adults with obesity, regardless of adjustment for metabolic demands or metabolically active tissue. This abstract was presented at the American Physiology Summit 2026 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.
Hoch et al. (Fri,) conducted a rct in Obesity (n=14). Inspiratory muscle strength training (IMST) vs. SHAM training at 15% of maximal inspiratory pressure was evaluated on Systolic blood pressure responses during exercise indexed to lower body lean mass (p=≥0.62). Inspiratory muscle strength training did not attenuate systolic blood pressure responses during peak exercise compared to sham among younger adults with obesity (interaction p≥0.62).