Biological Research for Nursing · Oct 28, 2026

Acute and Chronic Cardiovascular and Neuromuscular Effects of Blood Flow Restriction Resistance Training in Older Adults: A Systematic Review and Meta-Analysis

By Norouzi K, Nobari H, Jamali Masoomi S et al.

Low-load blood flow restriction resistance training (BFR-RT) may offer a lower-load alternative to conventional resistance training for older adults, but its cardiovascular responses and neuromuscular benefits remain incompletely characterized. To synthesize the acute cardiovascular responses and chronic cardiovascular and neuromuscular effects of low-load BFR-RT in older adults. PubMed/MEDLINE, Scopus, Web of Science, CENTRAL, and CINAHL were searched from inception to July 15, 2026. Randomized controlled trials, including parallel-group and crossover designs, comparing low-load BFR-RT with no-exercise/passive control or conventional non-BFR resistance training were eligible. Risk of bias was assessed using the Cochrane RoB 2 tool. Meta-analyses were performed using mean differences (MDs) with 95% confidence intervals (CIs). Twenty-seven studies were included. Acutely, BFR-RT increased systolic blood pressure versus no exercise (MD, 5.30 mmHg; 95% CI, 0.48 to 10.12) and increased diastolic blood pressure (MD, 5.23 mmHg) and mean arterial pressure (MD, 5.81 mmHg) versus conventional resistance training, while heart rate, stroke volume, and cardiac output were not significantly different. Chronically, resting cardiovascular and endothelial outcomes were largely unchanged. Versus no exercise, BFR-RT significantly improved knee-extension, leg-extension, and leg-press 1RM and quadriceps cross-sectional area. Comparisons with conventional resistance training were mixed and outcome-specific. Low-load BFR-RT improves selected neuromuscular outcomes in older adults, particularly relative to no exercise, while cardiovascular responses are comparator-dependent and chronic vascular effects appear largely neutral. These findings support cautious, individualized application rather than assumptions of cardiovascular superiority or equivalence to conventional resistance training.

doi.org/10.1177/10998004261502747PubMed 42950254Interventions