Repetitive remote ischemic preconditioning as a potential alternative intervention to attenuate arterial stiffness in individuals with elevated blood pressure

Elevated blood pressure (BP) is associated with increased arterial stiffness and risk of cardiovascular diseases (CVDs). Remote ischemic preconditioning (RIPC) involves three or four cycles of limb blood flow blockage followed by reperfusion with occlusion pressure between 200 and 220 mmHg and has been shown to improve vascular function. However, studies in normotensive adults showed no change in arterial stiffness, possibly due to shorter intervention periods (<1 wk). Therefore, the purpose of this study was to investigate the effects of 4 wk of RIPC on arterial stiffness in adults with elevated BP or stage 1 hypertension (EBP), and whether superoxide dismutase (SOD) levels account for this effect. We hypothesized that 4 wk of RIPC attenuates arterial stiffness measured by carotid-femoral pulse wave velocity (PWV) in individuals with EBP due to SOD upregulation. Young adults with normal blood pressure (NBP) (<i>n</i> = 11, 3 M/8 F, age = 21.0 ± 1.3 yr, BP = 102 ± 7/68 ± 4 mmHg) and EBP (<i>n</i> = 11, 8 M/3 F, age = 21.6 ± 1.6 yr, BP = 124 ± 6/78 ± 6 mmHg) underwent 4 wk of RIPC intervention, and the results showed that RIPC reduced PWV in the elevated BP group (5.66 ± 0.99 vs. 5.34 ± 0.77 m/s, <i>P</i> = 0.037). Furthermore, serum SOD activity was increased in EBP group after RIPC (13.18 ± 3.60 vs. 14.59 ± 4.02 units/mL, <i>P</i> = 0.016) with no significant changes in the normotensive group (<i>P</i> = 0.603). Thus, RIPC may serve as a potential alternative intervention to attenuate arterial stiffness likely via antioxidant upregulation in individuals with EBP.<b>NEW & NOTEWORTHY</b> Repeated RIPC attenuates arterial stiffness in the elevated or stage 1 hypertensive young adults but not in normotensive young adults. Increased SOD activity with repeated RIPC may explain the attenuated arterial stiffness in this population. These results underscore the potential of RIPC intervention to lower CVD risk through reductions in arterial stiffness and blood pressure in healthy young adults with elevated or stage 1 hypertensive blood pressure.