Chronic hemodynamic adaptations induced by resistance training with and without blood flow restriction in adults: A systematic review and meta-analysis

The purposes of this systematic review and meta-analysis of peer-reviewed literature were to examine the chronic effects of resistance training with blood flow restriction (RT-BFR) on hemodynamics, and to compare these adaptations to those induced by traditional resistance training (TRT) programs in adults (PROSPERO: Registry: CRD42022339510). A literature search was conducted across PubMed, Sports Discus, Scielo, and Web of Science databases. Two independent reviewers extracted study characteristics and blood pressure measures. Risk of bias (The Cochrane risk of bias tool for randomized controlled trials [RoB-2]), and the certainty of the evidence (Grading of Recommendations, Assessment, Development, and Evaluation [GRADE]) were used. A total of eight studies met the inclusion criteria for systolic (SBP), diastolic (DBP), and mean arterial pressure (MAP). Regarding the comparison of RT-BFR vs. non-exercise, no significant differences favoring the exercise group were observed (p ​> ​0.05). However, when compared to TRT, RT-BFR elicited additional improvements on DBP (−3.35; 95%CI -6.00 to −0.71; I² ​= ​14%; z ​= ​−2.48, p ​= ​0.01), and on MAP (−3.96; 95%CI -7.94 to 0.02; I² ​= ​43%; z ​= ​−1.95, p ​= ​0.05). Results indicate that RT-BFR may elicit a decrease in DBP in comparison with TRT, but the lack of data addressing this topic makes any conclusion speculative. Future research on this topic is warranted.