Effects of Low-Load Blood Flow Restriction Training on Hemodynamic Responses and Vascular Function in Older Adults: A Meta-Analysis

Background: The combination of low-load (LL) training with blood flow restriction (BFR) has recently been shown to trigger a series of hemodynamic responses and promote vascular function in various populations. To date, however, evidence is sparse as to how this training regimen influences hemodynamic response and vascular function in older adults. Objective: To systematically evaluate the effects of LL-BFR training on hemodynamic response and vascular function in older adults. Methods: A PRISMA-compliant systematic review and meta-analysis were conducted. The systematic literature research was performed in the following electronic databases from their inception to 30 February 2022: PubMed, Web of Science, Scopus, EBSCO host, the Cochrane Library and CNKI. Subsequently, a meta-analysis with inverse variance weighting was conducted. Results: A total of 1437 articles were screened, and 12 randomized controlled trials with a total 378 subjects were included in the meta-analysis. The meta-analysis results showed that LL-BFR training caused a significant acute increase in heart rate (WMD: 4.02, 95% CI: 0.93, 7.10, p < 0.05), systolic blood pressure (WMD: 5.05, 95% CI: 0.63, 9.48, p < 0.05) and diastolic blood pressure (WMD: 4.87, 95% CI: 1.37, 8.37, p < 0.01). The acute hemodynamic response induced by LL-BFR training is similar to that elicited by high-load (HL) training. Training volume, cuff pressure and width were identified as significant moderators in our subgroup and meta-regression analyses. After 30 min of training, resting systolic blood pressure significantly decreased (WMD: −6.595, 95% CI: −8.88, −3.31, p < 0.01) in the LL-BFR training group, but resting hemodynamic indexes exhibited no significant differences compared with common LL and HL training; long-term LL-BFR training resulted in significant improvements in flow-mediated vasodilation (FMD) (WMD: 1.30, 95% CI: 0.50, 2.10, p < 0.01), cardio ankle vascular index (CAVI) (WMD: 0.55, 95% CI: 0.11, 0.99, p < 0.05) and ankle brachial index (ABI) (WMD: 0.03, 95% CI: 0.00, 0.06, p < 0.05) in older adults. Conclusion: This systematic review and meta-analysis reveals that LL-BFR training will cause an acute hemodynamic response in older adults, which can return to normal levels 30 min after training, and systolic blood pressure significantly decreased. Furthermore, the beneficial effect of LL-BFR training on vascular function is to improve FMD, CAVI and ABI of older adults. However, due to the influence of the quality of the included studies and the sample size, more high-quality studies are needed to confirm such issues as BFR pressure and training risk.