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Blood flow restriction vs traditional resistance exercise: effects on heart rate variabilityTraditional lifting may stress the heart more than blood flow restriction training

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Key Takeaway
Consider that both BFR and traditional resistance exercise acutely alter HRV, with TRE showing larger effects; sex differences may exist for LF/HF ratio.

This randomized crossover trial included 39 trained adults (20 men, 19 women; mean age 23±4 years) who performed both blood flow restriction (BFR) resistance exercise (4 sets, 30-15-15-15 repetitions at 30% 1RM) and traditional resistance exercise (TRE) (4 sets × 10 repetitions at 70% 1RM) with 60-second rest between sets. The primary outcome was heart rate variability (HRV) normalized units for low frequency (LF), high frequency (HF), and LF/HF ratio.

Interaction effects were observed for LF and HF (both p < 0.05), with post-hoc analysis showing that LF increased and HF decreased postexercise, with greater effects in the TRE condition (all p < 0.05). No effect or interaction with sex was found for LF and HF (all p > 0.05). For LF/HF ratio, a sex-by-time interaction was observed (p < 0.05), with greater increases postexercise in men than in women across both conditions.

Safety and tolerability were not reported. Limitations include the small sample size and lack of reported funding or conflicts of interest. The study did not assess long-term outcomes or clinical endpoints.

These findings suggest that both BFR and TRE acutely alter autonomic balance, but the clinical relevance remains uncertain. Clinicians should consider these results preliminary and not overgeneralize to patient populations.

Thirty-nine healthy adults between 23 and 27 years old participated in a study comparing two types of resistance training. The group performed traditional resistance exercise with heavy weights, while another group used blood flow restriction training with lighter weights and a cuff on the limb. Both groups did four sets of exercises with one minute of rest between them. The researchers measured heart rate variability to see how the heart responded to the workout stress.

The results showed that traditional resistance exercise caused larger changes in heart rate signals than the blood flow restriction method. Specifically, the traditional method led to a bigger drop in high frequency heart rate signals and a bigger rise in low frequency signals. These changes indicate a stronger stress response on the heart and nervous system during the heavy lifting session. The study found no difference in these effects based on whether the participant was a man or a woman.

However, the study looked at a small group of only 39 people. This means the results might not apply to everyone. The researchers did not report any safety issues or side effects during the short workout. While the findings suggest traditional lifting creates more autonomic stress, more research is needed to confirm these patterns in larger groups of people.

What this means for you:
Traditional heavy lifting caused greater heart stress signals than lighter blood flow restriction training in this small group.

Study Details

Study typeRct
EvidenceLevel 2
PublishedMay 2026
View Original Abstract ↓
Perlet, MR, Mendonça, LI, Hosick, PA, Licameli, N, and Matthews, EL. Heart rate variability after blood flow restriction resistance exercise and traditional resistance exercise in trained men and women. J Strength Cond Res 40(5): 545-551, 2026-Autonomic nervous system responses are attenuated after blood flow restriction (BFR) resistance exercise vs. traditional resistance exercise (TRE) in men, but women's responses are unknown. The purpose of this investigation is to compare the effects of a single BFR vs. TRE session on HRV. Thirty-nine adults (M=20, W=19, age: 23±4yrs, body mass: 72.3±13.2kg, height: 169±9cm) participated in the study. Barbell back squat 1 repetition maximum (1RM) testing was performed followed by 2 randomized and counterbalanced exercise visits ≥48 hours apart (BFR: 4 sets, 30-15-15-15 repetitions, 30% 1RM, 60 s rest; TRE: 4 sets × 10 repetitions, 70% 1RM, 60 s rest). Pre- and postexercise resting electrocardiograms were analyzed using heart rate variability (HRV) normalized units for low frequency (LF), high frequency (HF), and LF/HF. Two-way repeated measures analysis of variances with sex as a between-subjects effect were analyzed (alpha p < 0.05). Both LF and HF displayed interaction effects (both p < 0.05) with no effect or interaction with sex (all p > 0.05). Post hoc testing found that LF increased and HF decreased postexercise, but with greater effects in the TRE condition (all p < 0.05). Low frequency/HF also increased postexercise, and there was a sex by time interaction (all p < 0.05). Post hoc testing found greater increases in LF/HF postexercise in men than in women ( p < 0.05) across exercise conditions. Both TRE and BFR increased sympathetic activity and decreased parasympathetic activity HRV indices, and the changes were attenuated for BFR in both sexes. However, men have a greater shift toward sympathetic dominance independent of exercise type. These changes in HRV indices may have beneficial applications for exercise training/recovery when trying to reduce autonomic stress.
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