Potential Implications of Blood Flow Restriction Exercise on Vascular Health: A Brief Review

  • Dahan da Cunha NascimentoEmail author
  • Brad J. Schoenfeld
  • Jonato Prestes
Review Article


Blood flow restriction (BFR) exercise (a.k.a. occlusion training) has emerged as a viable surrogate to traditional heavy-load strength rehabilitation training for a broad range of clinical populations including elderly subjects and rehabilitating athletes. A particular benefit of BFR exercise is the lower stress upon the joints as compared to traditional heavy resistance training, with similar gains in muscle strength and size. The application of an inflatable cuff to the proximal portion of the limbs increases the pressure required for venous return, leading to changes in venous compliance and wall tension. However, it is not known if long-term benefits of BFR exercise on muscle strength and size outweigh potential short and long-term complications on vascular health. BFR exercise could lead to clinical deterioration of the vasculature along with sympathetic overactivity and decreased vascular function associated with retrograde shear stress. This raises a fundamental question: Given the concern that excessive restriction could cause injury to endothelial cells and might cause detrimental effects on endothelial function, even in healthy individuals, should we critically re-evaluate the safety of this method for the general population? From this perspective, the purpose of this manuscript is to review the effects of BFR exercise on vascular function, and to provide relevant insights for training practice as well as future directions for research.



The first author would like to thank his family and in particular his mother Rita Cunha and his son Nicolas Cunha.

Author contributions

All authors contributed article preparation; took part in drafting the article and reviewing critically for important intellectual content; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.

Compliance with ethical standards


No sources of funding were received for the preparation of this article.

Conflict of interest

Dahan da Cunha Nascimento, Brad J. Schoenfeld and Jonato Prestes have no conflicts of interest directly relevant to the content of this article.


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Physical EducationCatholic University of Brasilia (UCB)BrasiliaBrazil
  2. 2.Department of Physical EducationUniversity Center of the Federal District (UDF)BrasiliaBrazil
  3. 3.Department of Health SciencesCUNY Lehman CollegeBronxUSA

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