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Central cardiovascular hemodynamic response to unilateral handgrip exercise with blood flow restriction



Exercise training with blood flow restriction (BFR) increases muscle size and strength. However, there is limited investigation into the effects of BFR on cardiovascular health, particularly central hemodynamic load.


To determine the effects of BFR exercise on central hemodynamic load (heart rate—HR, central pressures, arterial wave reflection, and aortic stiffness).


Fifteen males (age = 25 ± 2 years; BMI = 27 ± 2 kg/m2, handgrip max voluntary contraction-MVC = 50 ± 2 kg) underwent 5-min bouts (counter-balanced, 10 min rest between) of rhythmic unilateral handgrip (1 s squeeze, 2 s relax) performed with a moderate-load (60% MVC) with and without BFR (i.e., 71 ± 5% arterial inflow flow reduction, assessed via Doppler ultrasound), and also with a low-load (40% MVC) with BFR. Outcomes included HR, central mean arterial pressure (cMAP), arterial wave reflection (augmentation index, AIx; wave reflection magnitude, RM%), aortic arterial stiffness (pulse wave velocity, aPWV), and peripheral (vastus lateralis) microcirculatory response (tissue saturation index, TSI%).


HR increased above baseline and time control for all handgrip bouts, but was similar between the moderate load with and without BFR conditions (moderate-load with BFR =  + 9 ± 2; moderate-load without BFR =  + 8 ± 2 bpm, p < 0.001). A similar finding was noted for central pressure (e.g., moderate load with BFR, cMAP =  + 14 ± 1 mmHg, p < 0.001). No change occurred for RM% or AIx (p > 0.05) for any testing stage. TSI% increased during the moderate-load conditions (p = 0.01), and aPWV increased above baseline following moderate-load handgrip with BFR only (p = 0.012).


Combined with BFR, moderate load handgrip training with BFR does not significantly augment central hemodynamic load during handgrip exercise in young healthy men.

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Fig. 5



Augmentation Index


Augmentation pressure


Aortic pulse wave velocity


Blood flow restriction exercise


Blood pressure


Central mean arterial pressure

H+ :

Hydrogen ions


High-frequency component


Heart rate


Heart rate variability


Distance between sternal notch and carotid pulse site


Distance between sternal notch and proximal edge of thigh cuff


Low-frequency component


Low-frequency-to-high-frequency component ratio




Maximal voluntary contraction


Near-infrared spectroscopy


Backward pressure component


Forward pressure component


Pulse pressure


Reflection magnitude


Root mean square of standard deviation of R–R intervals


Rate pressure product


Standard deviation of R–R intervals


Tissue Saturation Index

V mean :

Mean blood velocity


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The authors would like to thank the participants for their time and dedication towards the study. The authors would also like to thank the students (graduate and undergraduate) from the School of Kinesiology and Nutrition at the University of Southern Mississippi for their support and assistance throughout the various stages of this project.

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Authors and Affiliations



DC, LS, and SM conceived, and designed research; DC, RJ, and SM conducted experiments; DC, RJ, DS, LS, and MJ analyzed data; DC and RJ drafted the manuscript. All authors read, edited, and approved the final manuscript for submission.

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Correspondence to Daniel P. Credeur.

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There are no conflicts of interest to report for this study.

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Communicated by Philip D Chilibeck.

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Credeur, D.P., Jones, R., Stanford, D. et al. Central cardiovascular hemodynamic response to unilateral handgrip exercise with blood flow restriction. Eur J Appl Physiol 119, 2255–2263 (2019).

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  • Vascular stiffness
  • Kaatsu
  • Autonomic function
  • Blood flow
  • Pulse wave reflection