Evidence map›Paper›PMID 31702969›Full record

ReviewAmerican journal of physiology. Heart and circulatory physiology2020

Clinical safety of blood flow-restricted training? A comprehensive review of altered muscle metaboreflex in cardiovascular disease during ischemic exercise.

Michelle Cristina-Oliveira, Kamila Meireles, Marty D Spranger, Donal S O'Leary, Hamilton Roschel, Tiago Peçanha

Registry-linked trialOpen access · bronzeAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in American journal of physiology. Heart and circulatory physiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04606654 (Effects of Handgrip Training With and Without Blood Flow Restriction in Relation to Gender Among Healthy Young Adults), which is not on this map. Cited by 60 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
60citing papers in PubMed, 4 pooled it
9.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04606654 nacompletednot on this map

Effects of Handgrip Training With and Without Blood Flow Restriction in Relation to Gender Among Healthy Young Adults

TypeinterventionalSponsorRiphah International UniversityRan2020 to 2021Enrolled56ConditionsSports Physical TherapyArmsHandgrip strength training without Blood flow restriction, Handgrip strength training with Blood flow restriction
3 · Its place in the literature

Who cites it

60 citing papers in PubMed, 4 syntheses or guidelines pooled it, 111 citations in OpenAlex.

  1. Pooled it
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  9. The effects of resistance exercise with blood flow restriction on muscle performance, muscle mass, and function in older adults: a systematic review.European review of aging and physical activity : official journal of the European Group for Research into Elderly and Physical Activity · 2026
    Review
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  12. Prognostic value of exercise blood pressure: role of fitness and exercise training.American journal of physiology. Heart and circulatory physiology · 2026
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 2 countries.

Michelle Cristina-OliveiraApplied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil.
Kamila MeirelesApplied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil.
Marty D SprangerDepartment of Physiology, Michigan State University, East Lansing, Michigan.
Donal S O'LearyDepartment of Physiology, Wayne State University School of Medicine, Detroit, Michigan.
Hamilton RoschelApplied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil.
Tiago PeçanhaApplied Physiology and Nutrition Research Group, School of Physical Education and Sport, Rheumatology Division, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil.ORCID 0000-0003-4968-5525
Universidade de São Paulo · BRMichigan State University · USWayne State University · US

Funding

BLOOD PRESSURE CONTROL DURING EXERCISE IN HEART FAILURER01HL055473 · NHLBI · WAYNE STATE UNIVERSITY · PI O'LEARY, DONAL S · 1996 to 2024
$9.8M
Mechanisms Mediating Enhanced Sympatho-Activation During Exercise in HypertensionR01HL126706 · NHLBI · WAYNE STATE UNIVERSITY · PI O'LEARY, DONAL S · 2016 to 2019
$2.2M
NHLBI NIH HHS R01 HL055473NHLBI NIH HHS R01 HL126706
6 · The paper itself

Abstract

Blood flow restriction training (BFRT) is an increasingly widespread method of exercise that involves imposed restriction of blood flow to the exercising muscle. Blood flow restriction is achieved by inflating a pneumatic pressure cuff (or a tourniquet) positioned proximal to the exercising muscle before, and during, the bout of exercise (i.e., ischemic exercise). Low-intensity BFRT with resistance training promotes comparable increases in muscle mass and strength observed during high-intensity exercise without blood flow restriction. BFRT has expanded into the clinical research setting as a potential therapeutic approach to treat functionally impaired individuals, such as the elderly, and patients with orthopedic and cardiovascular disease/conditions. However, questions regarding the safety of BFRT must be fully examined and addressed before the implementation of this exercise methodology in the clinical setting. In this respect, there is a general concern that BFRT may generate abnormal reflex-mediated cardiovascular responses. Indeed, the muscle metaboreflex is an ischemia-induced, sympathoexcitatory pressor reflex originating in skeletal muscle, and the present review synthesizes evidence that BFRT may elicit abnormal cardiovascular responses resulting from increased metaboreflex activation. Importantly, abnormal cardiovascular responses are more clearly evidenced in populations with increased cardiovascular risk (e.g., elderly and individuals with cardiovascular disease). The evidence provided in the present review draws into question the cardiovascular safety of BFRT, which clearly needs to be further investigated in future studies. This information will be paramount for the consideration of BFRT exercise implementation in clinical populations.

Indexed as

IschemiaMuscle ContractionReflexTherapeutic OcclusionAdaptation, PhysiologicalAnimalsAutonomic Nervous SystemChemoreceptor CellsEnergy MetabolismFemaleHemodynamicsHumansMaleMuscle, SkeletalPhysical Conditioning, HumanRegional Blood Flowautonomic nervous systemblood flow restriction trainingcardiac rehabilitationexercise pressor reflexKaatsu trainingsympathetic nervous system

Identifiers

PMID31702969
PMCPMC7002866
OpenAlexW2986161517

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.