What is the clinical evidence from this study?

Study design: Cohort. Population: Exercise-Induced Hypertension (EIH) (n=28). Intervention: Blood flow restriction (BFR) training vs. Habitual exercise routine (Control). Primary outcome: Maximal systolic blood pressure (SBPmax) (p=<0.001).

What question did this study set out to answer?

To evaluate the effects of blood flow restriction training on cardiovascular biomarkers and hemodynamic responses in middle-aged runners with exercise-induced hypertension.

May 3, 2026Journal of Sports Science and Medicine0 citationsOpen Access

Blood Flow Restriction Training Reduces Hemodynamic Load and Improves Cardiovascular Biomarkers in Runners with Exercise-Induced Hypertension

Q: What are the key findings of this study?

An 8-week blood flow restriction training program significantly reduced maximal systolic blood pressure (182.2 vs 212.0 mmHg) and improved cardiovascular biomarkers in runners with exercise-induced hypertension.

Q: What question did this study set out to answer?

To evaluate the effects of blood flow restriction training on cardiovascular biomarkers and hemodynamic responses in middle-aged runners with exercise-induced hypertension.

YKYoung-Joo KimSungshin Women's University CPChoung-Hwa ParkKyonggi University HPHan-Soo Park

Key Result

An 8-week blood flow restriction training program significantly reduced maximal systolic blood pressure (182.2 vs 212.0 mmHg) and improved cardiovascular biomarkers in runners with exercise-induced hypertension.

Key Points

To evaluate the effects of blood flow restriction training on cardiovascular biomarkers and hemodynamic responses in middle-aged runners with exercise-induced hypertension.
28 male runners with exercise-induced hypertension participated, aged 57.4 ± 6.5 years.
Participants were assigned to either a blood flow restriction training group (n=16) or a control group (n=12).
BFR training was performed twice weekly for 20 minutes over 8 weeks, including assessments of cardiovascular biomarkers pre- and post-intervention.
In the BFR training group, endothein-1, hs-CRP, and NT-proBNP levels significantly decreased (all p < .05).
Maximal systolic blood pressure and rate-pressure product decreased significantly (all p < .05).
Cardiorespiratory fitness improved as indicated by higher VO₂max after the intervention.

Study Design

Type

Cohort (n=28)

Multicenter

Structured PICO

Does blood flow restriction training improve cardiovascular biomarkers and hemodynamic load in middle-aged male runners with exercise-induced hypertension?

Population

28 male runners with exercise-induced hypertension (EIH) exhibiting a maximal systolic blood pressure ≥210 mmHg during graded exercise testing, mean age 57.4 ± 6.5 years.

Intervention

Blood flow restriction (BFR) training performed twice weekly for 20 minutes over 8 weeks.

Comparator

Control group (non-BFR training).

Outcome

Changes in cardiovascular biomarkers (endothelin-1 [ET-1], high-sensitivity C-reactive protein [hs-CRP], NT-proBNP, and nitric oxide [NO]) and hemodynamic response (maximal systolic blood pressure, VO2max, rate-pressure product, pulse pressure) pre- and post-intervention.surrogate

Blood flow restriction training over 8 weeks improves exercise blood pressure response, cardiorespiratory fitness, and cardiovascular biomarkers in middle-aged male runners with exercise-induced hypertension.

Main Result

Absolute Event Rate: 182.2% vs 212%

p-value: p=<0.001

Limitations

Exclusion of participants based on factors influencing hematological parameters limits generalizability
Pre-analytical and analytical variables were not fully controlled
Secondary analysis of an existing cohort with a potentially insufficient sample size
Biomarkers were measured within a single institution across limited analytical batches
Nitric oxide was assessed at a single time point without dynamic response evaluation
Repeated comparisons of four biomarkers increase the risk of Type I error
Lifestyle factors such as hydration, diet, and sleep were not strictly standardized
Antihypertensive medication use and blood pressure control were not strictly standardized
Cuff pressure was not individualized to Doppler-derived arterial occlusion pressure (AOP)
Exercise exposure outside the intervention was not strictly standardized or controlled

Abstract

Exercise-induced hypertension (EIH) is associated with elevated risks of arrhythmia, coronary artery disease, arterial stiffness, and sudden cardiac death. Blood flow restriction (BFR) training has been proposed as a non-pharmacological intervention. This study aimed to evaluate whether changes in cardiovascular biomarkers accompanied hemodynamic improvements following BFR training in middle-aged runners with EIH. This secondary analysis included 28 male runners with EIH (mean age: 57.4 ± 6.5 years) from a prior cohort applying the same BFR training protocol. Participants exhibited a maximal systolic blood pressure ≥210 mmHg during graded exercise testing (GXT) and were assigned to a BFR training group (BFRTg, n = 16) or a control group (non-BFRTg, n = 12). BFR training was performed twice weekly for 20 minutes over 8 weeks. Cardiorespiratory fitness and hemodynamic response during GXT were also assessed. Cardiovascular biomarkers (endothelin-1 ET-1, high-sensitivity C-reactive protein hs-CRP, NT-proBNP, and nitric oxide NO) were measured pre- and post-intervention. In the BFRTg, ET-1, hs-CRP, and NT-proBNP levels decreased after BFR training, while maximal systolic blood pressure decreased and VO2max increased (all p .05). Hemodynamic load also improved, as indicated by reductions in resting and maximal rate-pressure product (RPP) and pulse pressure during maximal exercise (all p .05). BFR training improved the exercise blood pressure response and cardiorespiratory fitness in runners with EIH. The reduction in hemodynamic load, reflected by decreases in RPP and PP, was accompanied by significant reductions in ET-1, hs-CRP, and NT-proBNP.

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