Blood Flow Restriction Training Reduces Hemodynamic Load, Improves Cardiovascular Biomarkers in Runners with EIH

Exercise-induced hypertension (EIH), characterized by an exaggerated blood pressure response during physical activity, significantly elevates the risk of serious cardiovascular events including arrhythmia, coronary artery disease, arterial stiffness, and sudden cardiac death. Current management often involves lifestyle modifications, but effective non-pharmacological interventions are needed. Blood flow restriction (BFR) training, a method involving low-load exercise with partial limb occlusion, has emerged as a promising strategy to induce physiological adaptations. This study investigates whether BFR training can mitigate the hemodynamic burden and improve key cardiovascular biomarkers such as endothelin-1 (ET-1), high-sensitivity C-reactive protein (hs-CRP), NT-proBNP, and nitric oxide (NO) in this high-risk population.

This secondary analysis included 28 middle-aged male runners (mean age: 57.4 ± 6.5 years) diagnosed with EIH (maximal systolic blood pressure ≥210 mmHg during GXT). Participants were assigned to either a BFR training group (BFRTg, n=16) or a control group (non-BFRTg, n=12). The BFR training protocol involved twice-weekly sessions, each lasting 20 minutes, over an 8-week period. Cardiorespiratory fitness, assessed via VO2max, and hemodynamic responses during GXT were primary endpoints. Pre- and post-intervention, cardiovascular biomarkers including endothelin-1, hs-CRP, NT-proBNP, and nitric oxide were quantified.

In the BFRTg, significant improvements were observed across multiple cardiovascular parameters. Levels of endothelin-1, hs-CRP, and NT-proBNP all decreased substantially after the 8-week BFR training period (all p < .05). Concurrently, maximal systolic blood pressure during GXT decreased, and VO2max, a key indicator of cardiorespiratory fitness, significantly increased (both p < .05). The hemodynamic load experienced by these runners also improved markedly. This was evidenced by significant reductions in both resting and maximal rate-pressure product (RPP) and a decrease in pulse pressure during maximal exercise (all p < .05). These findings collectively indicate a broad positive impact of BFR training on cardiovascular health in this vulnerable population. Notably, nitric oxide levels did not show a statistically significant change.

BFR training significantly reduced maximal systolic blood pressure and improved cardiorespiratory fitness, accompanied by reductions in inflammatory (hs-CRP) and cardiac stress (NT-proBNP) biomarkers.