Research Commentary
BFR Training and Exercise-Induced Hypertension in Runners
Article: Kim Y-J, Park C-H, Park H-S, Lim Y-E. Blood Flow Restriction Training Reduces Hemodynamic Load and Improves Cardiovascular Biomarkers in Runners with Exercise-Induced Hypertension. Journal of Sports Science and Medicine. 2026;25:371-380.
Practical takeaway: In this specific group of middle-aged male runners with exercise-induced hypertension, 8 weeks of BFR training was associated with lower maximal exercise systolic blood pressure, reduced hemodynamic load, improved VO2max, and favorable changes in several cardiovascular biomarkers.
This recent study examined blood flow restriction training in middle-aged male runners with exercise-induced hypertension. Exercise-induced hypertension was defined as a maximal systolic blood pressure of at least 210 mmHg during a graded exercise test.
The study was a secondary analysis of a prior cohort. Twenty-eight runners were included: 16 in the BFR training group and 12 in the non-BFR control group. The BFR group trained twice per week for 20 minutes over 8 weeks. The researchers measured graded exercise test responses and several cardiovascular biomarkers before and after the intervention, including endothelin-1, high-sensitivity C-reactive protein, NT-proBNP, and nitric oxide.
What They Found
After the training period, the BFR group showed a reduction in maximal exercise systolic blood pressure and improvements in VO2max compared with the non-BFR group. Measures of hemodynamic load also improved, including reductions in resting and maximal rate-pressure product and lower pulse pressure during maximal exercise.
The biomarker findings were also notable. Endothelin-1, high-sensitivity C-reactive protein, and NT-proBNP decreased in the BFR group. These markers are related to vascular tone, inflammation, and myocardial wall stress. Nitric oxide did not show a clear between-group change.
Main Takeaway
This study suggests that BFR training may have cardiovascular effects beyond strength or hypertrophy adaptations, at least in this very specific population of runners with exercise-induced hypertension. The findings point toward possible improvements in exercise blood pressure response, myocardial workload, and biomarkers related to vascular and inflammatory stress.
That said, this should be interpreted cautiously. The sample was small, all participants were male runners, and this was a secondary analysis rather than a larger trial designed specifically to test these biomarker outcomes. The BFR pressure protocol was also not individualized using arterial occlusion pressure, which is an important methodological consideration for modern BFR practice.
For practitioners, the paper is interesting because it adds to the idea that BFR may influence vascular and cardiovascular responses. It does not mean BFR should be broadly prescribed for cardiovascular risk management, but it does support the need for larger, well-controlled studies in clinical and athletic populations.