The Effectiveness of Blood Flow Restriction Training on Metabolic and Functional Parameters in Hypertensive and Dyslipidemic Elderly: A Randomised Controlled Trial

Hypertension and dyslipidemia are major modifiable cardiovascular risk factors among older adults and are highly prevalent in Indonesia. Low-load resistance training with blood flow restriction (BFR-RT) permits low external loads while eliciting favorable metabolic and functional adaptations, making it a potentially feasible alternative in primary care. To evaluate the effects of low-load BFR-RT on co-primary cardiometabolic outcomes (blood pressure and lipid profile) and secondary functional outcomes in older adults attending a community-based primary health care clinic. In this randomized controlled trial, 26 older adults were assigned to either a BFR-RT group or a control group performing the same low-load resistance exercises without blood flow restriction. Training was conducted twice weekly for 12 weeks. Blood flow restriction was applied using pneumatic cuffs set at 40% of individually determined arterial occlusion pressure. Co-primary outcomes included blood pressure and fasting lipid profile. Secondary outcomes were handgrip strength, Short Physical Performance Battery (SPPB) score, and estimated 10-year ASCVD risk. After 12 weeks, participants in the BFR-RT group demonstrated significantly greater improvements in blood pressure, LDL-cholesterol, and HDL-cholesterol compared with the control group. Between-group differences in total cholesterol and triglycerides were not statistically significant. Improvements in estimated ASCVD risk were also observed in the BFR-RT group, reflecting favorable changes in its component risk factors. Adherence exceeded 80% in both groups, with no serious adverse events. In this small trial, low-load BFR-RT was associated with greater improvements in several cardiometabolic and functional outcomes than resistance training alone in older adults in primary care. Given the limited sample size, these preliminary findings should be confirmed in larger, adequately powered trials.