Impact of Low-Intensity Occlusive Cardiorespiratory Training on Office Blood Pressure and Physical Fitness in Adults with Hypertension

Q: What are the key findings of this study?

Low-intensity continuous training with blood flow restriction (LICT-BFR) significantly reduced office diastolic blood pressure by 4 mmHg (p=0.044) and improved physical fitness over 12 weeks.

Q: What is the clinical evidence from this study?

Study design: RCT. Population: Hypertension (n=52). Intervention: Supervised cardiorespiratory training: low-intensity continuous training with blood flow restriction (LICT-BFR), moderate-intensity continuous training (MICT), or high-intensity interval training (HIIT) vs. Non-randomized convenience control group receiving WHO physical-activity advice. Primary outcome: Change in office diastolic blood pressure (DBP) in the LICT-BFR group (MD -4 mmHg, p=0.044).

Q: What does this research mean for the field?

Low-intensity continuous cardiorespiratory training with blood flow restriction produces physical fitness improvements comparable to traditional aerobic training and significantly reduces office diastolic blood pressure in adults with hypertension. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

M. Santa María; J. Minetto; G. Cerri; S. Collado; M. Barreda¹; F. Staropoli; W. Espeche

doi:10.21203/rs.3.rs-11375374/v1

November 3, 2026Open Access

Impact of Low-Intensity Occlusive Cardiorespiratory Training on Office Blood Pressure and Physical Fitness in Adults with Hypertension

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Key result

LICT-BFR reduces office diastolic blood pressure by ~4 mmHg over 12 weeks.

MD -4 mmHg
P=0.044
n=52

Why the study?

While moderate-intensity continuous training (MICT) and high-intensity interval training (HIIT) are well supported for hypertension, low-intensity cardiorespiratory training with blood flow restriction (LICT-BFR) has emerged as a lower-workload alternative requiring comparison against established exercise modalities and control.

Does a 12-week supervised low-intensity continuous cardiorespiratory training program with blood flow restriction (LICT-BFR) reduce office blood pressure and improve physical fitness compared with MICT, HIIT, and a control group in sedentary adults with hypertension?

Key Points

To compare the effects of high-intensity interval training, moderate-intensity continuous training, and low-intensity continuous training with blood flow restriction against a control group on office blood pressure and physical fitness in adults with hypertension.
Conducted a randomized controlled clinical study in Argentina with 52 adults with hypertension (mean age 60 ± 6 years; 37 allocated to exercise protocols and 15 assigned to a convenience control group).
Intervention groups completed 36 sessions (3 sessions weekly for 12 weeks) of high-intensity interval training (n = 10), moderate-intensity continuous training (n = 13), or low-intensity continuous training with blood flow restriction (n = 14).
A total of 38 participants completed the study (26.9% loss to follow-up); combined exercise groups showed significant improvements in physical fitness and office blood pressure compared with controls (p < 0.05), with no changes in body weight or waist circumference.
All three exercise protocols improved physical fitness, but only low-intensity continuous training with blood flow restriction demonstrated a statistically significant reduction in office diastolic blood pressure (p = 0.044).
During exercise sessions, low-intensity training with blood flow restriction resulted in significantly lower mean peak systolic blood pressure (163 mmHg vs. 179 mmHg, p < 0.05) and myocardial oxygen consumption (19,955 vs. 23,104, p = 0.006) than high-intensity interval training.

Study Design

Type

RCT (n=52)

Randomization

Simple computerized randomization to the three exercise intervention groups (HIIT, MICT, LICT-BFR); control group was non-randomized convenience sample

Multicenter

No

Structured PICO

Does a 12-week supervised low-intensity continuous cardiorespiratory training program with blood flow restriction (LICT-BFR) reduce office blood pressure and improve physical fitness compared with MICT, HIIT, and a control group in sedentary adults with hypertension?

P

Population

52 sedentary adults (aged 55-76 years, 57% female at screening) with hypertension and free of prior cardiovascular disease or beta-blocker/anticoagulant use, followed for 12 weeks in Argentina.

I

Intervention

12-week supervised cardiorespiratory exercise program on a mechanical cycle ergometer (36 sessions, 3 times per week on non-consecutive days) randomly allocated across three modalities: (1) Low-Intensity Continuous Training with Blood Flow Restriction (LICT-BFR, n=14) using bilateral proximal thigh 10-12 cm pneumatic cuffs; (2) Moderate-Intensity Continuous Training (MICT, n=13) at 50-70% VO2max for 15-30 minutes; or (3) High-Intensity Interval Training (HIIT, n=10) alternating 80-95% VO2max intervals with 40-50% VO2max active recovery.

C

Comparator

Non-randomized convenience control group (n=15) consisting of patients unable or unwilling to attend the hospital gym who received physical-activity advice based on World Health Organization recommendations for adults.

O

Outcome

Changes in office blood pressure (systolic and diastolic BP, measured as the mean of three readings) and physical fitness (handgrip strength, 30-Second Sit-to-Stand test, Five-Times Sit-to-Stand test, and estimated VO2max/METs via submaximal Åstrand-Ryhming cycle-ergometer test) at 12 weeks.surrogate

Main Result

Mean Difference: -4

p-value: p=0.044

Supervised low-intensity aerobic cycling with blood flow restriction (LICT-BFR) lowers office diastolic blood pressure and improves functional fitness similarly to traditional aerobic training while eliciting lower peak exercise systolic blood pressure and myocardial workload, offering a viable alternative for hypertensive patients who cannot tolerate higher exercise intensities.

Limitations

Relatively small sample size, particularly for comparisons among the three training modalities, limiting statistical power to detect between-protocol differences
Control group was not randomized, so selection bias cannot be ruled out
Short 12-week intervention duration, so long-term persistence of benefits cannot be established
High loss to follow-up (26.9%; 14 of 52 participants did not complete follow-up)
Dietary intake was not strictly controlled during follow-up
Small sample size (52 allocated, 38 completed), limiting statistical power to detect differences among the three training protocols
Non-randomized convenience control group, introducing potential selection bias
Short 12-week follow-up duration, precluding assessment of long-term persistence of benefits
Loss to follow-up of 26.9% (14 dropouts)

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Implication

LICT-BFR offers a low-intensity option for diastolic BP reduction in hypertension; extends aerobic training evidence to include blood flow restriction.

Abstract

Background Hypertension is the leading modifiable risk factor for cardiovascular morbidity and mortality, underscoring the need for non-pharmacological strategies such as exercise to optimize blood pressure control. Although moderate-intensity continuous training (MICT) and high-intensity interval training (HIIT) are supported by substantial evidence, blood flow restriction (BFR) combined with low-intensity cardiorespiratory training (LICT) has emerged as a promising alternative because it imposes a lower workload. Objective To compare the effects of three cardiorespiratory training modalities—high-intensity interval training (HIIT), moderate-intensity continuous training (MICT), and low-intensity continuous training with blood flow restriction (LICT-BFR)—with those of a control group on office blood pressure and physical fitness in patients with hypertension. Methods This randomized controlled clinical study was conducted at the Cardiometabolic Diseases Unit of Hospital Interzonal General de Agudos San Martín in La Plata, Argentina. Sixty participants were assessed (mean age, 60 ± 6 years). After eight participants were excluded for clinical reasons, 52 participants remained: a control group (n = 15) and three exercise groups—HIIT (n = 10), MICT (n = 13), and LICT-BFR (n = 14). The intervention comprised 36 sessions, three times per week for 12 weeks. Results Loss to follow-up was 26.9%, and 38 participants completed the study. Compared with the control group, the exercise groups combined showed significant improvements in physical fitness and office blood pressure (p < 0.05), with no changes in body weight or waist circumference. All three protocols improved physical fitness; however, only LICT-BFR produced a statistically significant reduction in office diastolic blood pressure (DBP; p = 0.044). Conclusion Cardiorespiratory training is important for improving functional capacity and hemodynamic control in people with hypertension. LICT-BFR provided functional benefits comparable to those of traditional aerobic training and was associated with a statistically significant reduction in office DBP.

Discussion

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Cite This Study

María et al. (2026) conducted an RCT in Hypertension (n=52). Supervised cardiorespiratory training: low-intensity continuous training with blood flow restriction (LICT-BFR), moderate-intensity continuous training (MICT), or high-intensity interval training (HIIT) vs. Non-randomized convenience control group receiving WHO physical-activity advice was evaluated on Change in office diastolic blood pressure (DBP) in the LICT-BFR group (MD -4 mmHg, p=0.044). Low-intensity continuous training with blood flow restriction (LICT-BFR) significantly reduced office diastolic blood pressure by 4 mmHg (p=0.044) and improved physical fitness over 12 weeks.

synapsesocial.com/papers/6aea772189a8acbed9c87abd https://doi.org/10.21203/rs.3.rs-11375374/v1

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Impact of Low-Intensity Occlusive Cardiorespiratory Training on Office Blood Pressure and Physical Fitness in Adults with Hypertension

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Impact of Low-Intensity Occlusive Cardiorespiratory Training on Office Blood Pressure and Physical Fitness in Adults with Hypertension

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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