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Zota IM, Ghiciuc CM, Cojocaru DC, Dima-Cozma CL, Leon MM, Gavril RS, Roca M, Costache AD, Maștaleru A, Anghel L, Stătescu C, Sascău RA, Mitu F. Changes in Arterial Stiffness in Response to Blood Flow Restriction Resistance Training: A Narrative Review. J Clin Med 2023; 12:7602. [PMID: 38137671 PMCID: PMC10743779 DOI: 10.3390/jcm12247602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
Arterial stiffness naturally increases with age and is a known predictor of cardiovascular morbimortality. Blood flow restriction (BFR) training involves decreasing muscle blood flow by applying a strap or a pneumatic cuff during exercise. BFR induces muscle hypertrophy even at low intensities, making it an appealing option for older, untrained individuals. However, BFR use in patients with cardiovascular comorbidities is limited by the increased pressor and chronotropic response observed in hypertensive elderly patients. Furthermore, the impact of BFR on vascular function remains unclear. We conducted a comprehensive literature review according to PRISMA guidelines, summarizing available data on the acute and long-term consequences of BFR training on vascular function. Although evidence is still scarce, it seems that BFR has a mild or neutral long-term impact on arterial stiffness. However, current research shows that BFR can cause an abrupt, albeit transient, increase in PWV and central blood pressure. BFR and, preferably, lower-body BFR, should be prescribed with caution in older populations, especially in hypertensive patients who have an exacerbated muscle metaboreflex pressor response. Longer follow-up studies are required to assess the chronic effect of BFR training on arterial stiffness, especially in elderly patients who are usually unable to tolerate high-intensity resistance exercises.
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Affiliation(s)
- Ioana Mădălina Zota
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Cristina Mihaela Ghiciuc
- Pharmacology, Clinical Pharmacology and Algeziology, Department of Morpho-Functional Sciences II, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania
| | - Doina Clementina Cojocaru
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Corina Lucia Dima-Cozma
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Maria Magdalena Leon
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Radu Sebastian Gavril
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Mihai Roca
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Alexandru Dan Costache
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Alexandra Maștaleru
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Larisa Anghel
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Cristian Stătescu
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Radu Andy Sascău
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
| | - Florin Mitu
- Department of Medical Specialties I, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iași, Romania; (I.M.Z.); (C.L.D.-C.); (M.M.L.); (R.S.G.); (M.R.); (A.D.C.); (A.M.); (L.A.); (C.S.); (R.A.S.); (F.M.)
- Academy of Medical Sciences of Romania, Ion C. Brătianu Boulevard No 1, 030167 Bucharest, Romania
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Maga M, Wachsmann-Maga A, Batko K, Włodarczyk A, Kłapacz P, Krężel J, Szopa N, Sliwka A. Impact of Blood-Flow-Restricted Training on Arterial Functions and Angiogenesis-A Systematic Review with Meta-Analysis. Biomedicines 2023; 11:1601. [PMID: 37371696 DOI: 10.3390/biomedicines11061601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 05/29/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
Despite growing evidence of the significant influence of blood-flow-restricted (BFR) training on different body functions, its impact on the vascular system, especially the arteries, is controversial. Therefore, the objective of our study was to analyze how BFR exercise, compared to other types of exercise without the restriction of blood flow, influences arterial functions and angiogenesis in adults. Studies comparing the effect of BFR versus non-BFR training on arterial parameters were divided into three categories: endothelial function, angiogenesis, and other vasculature functions. The search was based on Cochrane Library, PubMed®, and Embase, and 38 studies were included. The meta-analysis revealed a more significant improvement in flow-mediated dilatation (FMD) (p = 0.002) and the production of the primary angiogenesis biomarker vascular endothelial growth factor (VEGF) (p = 0.009) after BFR compared to non-BFR training (p = 0.002). The analysis of the pulse wave velocity, ankle-brachial index, systolic blood pressure, and heart rate did not show significant differences in changes between BFR and non-BFR training. The other parameters examined did not have sufficient data to be included in the meta-analysis. The results obtained present trends that suggest significant impacts of BFR training on endothelial functions and angiogenesis. There is still a lack of multicenter randomized clinical trials including many participants, and such studies are necessary to confirm the advantage of BFR over non-BFR activity.
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Affiliation(s)
- Mikołaj Maga
- Department of Rehabilitation in Internal Diseases, Faculty of Health Sciences, Jagiellonian University Medical College, 31-008 Krakow, Poland
- Clinical Department of Angiology, University Hospital in Krakow, 30-688 Krakow, Poland
| | - Agnieszka Wachsmann-Maga
- Clinical Department of Angiology, University Hospital in Krakow, 30-688 Krakow, Poland
- Department of Angiology, Faculty of Medicine, Jagiellonian University Medical College, 31-008 Krakow, Poland
| | - Krzysztof Batko
- Department of Research and Design, Medicine Economy Law Society (MELS) Foundation, 30-040 Krakow, Poland
| | - Aleksandra Włodarczyk
- Department of Angiology, Faculty of Medicine, Jagiellonian University Medical College, 31-008 Krakow, Poland
| | - Paulina Kłapacz
- Clinical Department of Angiology, University Hospital in Krakow, 30-688 Krakow, Poland
- Department of Angiology, Faculty of Medicine, Jagiellonian University Medical College, 31-008 Krakow, Poland
| | - Jakub Krężel
- Clinical Department of Angiology, University Hospital in Krakow, 30-688 Krakow, Poland
| | - Natalia Szopa
- Department of Angiology, Faculty of Medicine, Jagiellonian University Medical College, 31-008 Krakow, Poland
| | - Agnieszka Sliwka
- Department of Rehabilitation in Internal Diseases, Faculty of Health Sciences, Jagiellonian University Medical College, 31-008 Krakow, Poland
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