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

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), VO_₂max, 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 VO_₂max 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.

Keywords: blood flow restriction; exercise-induced hypertension; graded exercise test; long-distance runner.

Figure 1

Flow chart of study procedure. GXT: graded exercise testing; BFRG: blood flow restriction group.

Figure 2

Changes in RPP in GXT before and after BFR training. RRPP: rest rate pressure product; S: stage; MRPP: maximum rate pressure product; R: recovery; BFRG: blood flow restriction group; *: significant difference between pre- and post-exercise at p < 0.05.

Figure 3

Changes in maximal blood pressure in response to BFR training. BFRG: blood flow restriction group; SBP: systolic blood pressure; DBP: diastolic blood pressure. * Significant difference in SBP between BFRG and non-BFRG (p < 0.05); †: Significant difference in DBP between BFRG and non-BFRG (p < 0.05).