Blood Flow Restriction Training as a Non-Pharmacologic Therapy with Exercise-Induced Hypertension

Q: What are the key findings of this study?

Blood flow restriction training significantly reduced maximal systolic blood pressure by 43.1 mmHg compared to a 5.2 mmHg reduction in the control group among male runners with exercise-induced hypertension.

Q: What is the clinical evidence from this study?

Study design: RCT. Population: Exercise-induced hypertension (EIH) (n=33). Intervention: Blood flow restriction (BFR) training vs. Non-BFR aerobic training at 40-60% HRR for 20 min twice weekly. Primary outcome: Absolute change in maximal systolic blood pressure (MSBP) during graded exercise testing (p=<0.05).

Q: What does this research mean for the field?

Blood flow restriction training significantly reduces resting and maximal systolic and diastolic blood pressure and increases VO₂max and ventilatory threshold in male runners with exercise-induced hypertension. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Young‐Joo Kim; Ick-Mo Chung; Choung-Hwa Park; Jong‐Young Lee

doi:10.3390/jcm14134466

June 23, 2025Journal of Clinical MedicineOpen Access

Blood Flow Restriction Training as a Non-Pharmacologic Therapy with Exercise-Induced Hypertension

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Key result

Blood flow restriction training cuts maximal systolic BP by ~38 mmHg in runners with exercise-induced hypertension.

P<0.05
n=33

Figures

Why the study?

Long-distance runners with exercise-induced hypertension face increased cardiovascular risk, but the effects of blood flow restriction training in this population remain understudied.

Does blood flow restriction training improve cardiovascular responses and exercise performance in middle-aged male long-distance runners with exercise-induced hypertension?

Study Design

Type

RCT (n=33)

Randomization

Computer-generated random sequence

Multicenter

No

Structured PICO

Does blood flow restriction training improve cardiovascular responses and exercise performance in middle-aged male long-distance runners with exercise-induced hypertension?

P

Population

33 middle-aged male long-distance runners with exercise-induced hypertension (peak SBP ≥ 210 mmHg) were randomized to 8 weeks of aerobic training with or without blood flow restriction.

I

Intervention

Blood flow restriction (BFR) training combined with aerobic treadmill exercise at 40–60% heart rate reserve (HRR) for 20 minutes, twice weekly for 8 weeks. A fixed stepwise occlusion pressure protocol (standard Kaatsu unit, SKU) was applied to the proximal thigh using Cycle and Constant modes.

C

Comparator

Non-BFR aerobic training (treadmill exercise at 40–60% HRR for 20 minutes, twice weekly for 8 weeks without blood flow restriction).

O

Outcome

Changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), rate pressure product (RPP), ventilatory threshold (VT), VO₂max, and perceived exertion at rest, during exercise, and during recovery before and after the 8-week intervention.surrogate

Main Result

Absolute Event Rate: -43.1% vs -5.2%

p-value: p=<0.05

Blood flow restriction training during low-to-moderate intensity aerobic exercise significantly reduces maximal blood pressure and myocardial workload in male runners with exercise-induced hypertension.

Limitations

Inability to fully control for individual lifestyle factors such as physical activity levels, alcohol consumption, diet, and sleep.
Small sample size consisting entirely of middle-aged males, limiting generalizability.
Presence of subclinical or undetected cardiovascular conditions cannot be entirely ruled out.
Lack of real-time hemodynamic assessments during the BFR exercise sessions to evaluate acute cardiovascular responses.
BFR stimulus was not individualized using arterial occlusion pressure (AOP) percentages.
Real-time physiological and molecular assessments (e.g., catecholamines, VEGF, RAAS markers) were not performed.
Subendocardial viability ratio (SEVR) could not be calculated due to lack of continuous blood pressure monitoring.
Long-term effects beyond the two-month training period were not assessed.
Could not fully control for individual lifestyle factors such as physical activity levels, alcohol consumption, diet, and sleep
Small sample size, and all participants were middle-aged males, limiting generalizability
Did not include any real-time hemodynamic assessments during the BFR exercise sessions to evaluate acute cardiovascular responses
Did not individualize the BFR stimulus using arterial occlusion pressure (AOP) percentages, relying instead on a fixed pressure protocol
Long-term effects of the intervention beyond the two-month training period were not assessed

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Implication

BFR training may lower maximal SBP during exercise in male runners with exercise-induced hypertension; extends vascular benefits seen in other populations.

Abstract

Background/Objectives: Long-distance runners with exercise-induced hypertension (EIH) are at increased risk for cardiovascular complications. Although blood flow restriction (BFR) training has shown promise in improving vascular function, hemodynamic response, and cardiorespiratory fitness, its effects in EIH runners remain understudied. This study aimed to evaluate the effects of BFR training on cardiovascular responses and exercise performance in this population as a potential non-pharmacological therapy. Methods: Middle-aged male long-distance runners aged 40–65 with peak systolic blood pressure (SBP) ≥ 210 mmHg during graded exercise testing were randomly assigned to either a BFR group (n = 18) or a non-BFR control group (n = 15) using a computer-generated random sequence. There were no significant differences in baseline characteristics between the groups. Both groups performed aerobic training at 40–60% HRR for 20 min twice weekly for 8 weeks. SBP, diastolic blood pressure (DBP), rate pressure product (RPP), ventilatory threshold (VT), VO₂max, and perceived exertion were assessed before and after the intervention at rest, during exercise, and during recovery. Results: Compared to the non-BFR group, the BFR group showed statistically significant reductions in resting and maximal SBP and DBP (p < 0.05), along with significant increases in VO₂max and VT (p < 0.05). During submaximal exercise and post-exercise recovery, SBP and RPP were significantly lower in the BFR group (p < 0.05). The reductions in maximal SBP and DBP were significantly greater in the BFR group than in the control group. Conclusions: BFR training led to reduced myocardial workload and enhanced cardiovascular efficiency in male runners with EIH. These findings suggest that BFR training may be a viable non-pharmacological therapy for mitigating cardiovascular risks associated with EIH. Future studies should explore the long-term effects of BFR in broader populations and assess its applicability in clinical settings.

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Cite This Study

Kim et al. (2025) conducted an RCT in Exercise-induced hypertension (EIH) (n=33). Blood flow restriction (BFR) training vs. Non-BFR aerobic training at 40-60% HRR for 20 min twice weekly was evaluated on Absolute change in maximal systolic blood pressure (MSBP) during graded exercise testing (p=<0.05). Blood flow restriction training significantly reduced maximal systolic blood pressure by 43.1 mmHg compared to a 5.2 mmHg reduction in the control group among male runners with exercise-induced hypertension.

synapsesocial.com/papers/6a17f44bd990e918e6b4b9b6 https://doi.org/10.3390/jcm14134466

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Blood Flow Restriction Training as a Non-Pharmacologic Therapy with Exercise-Induced Hypertension

Figures

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Blood Flow Restriction Training as a Non-Pharmacologic Therapy with Exercise-Induced Hypertension

Figures

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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