Personalized blood flow restriction training at variable occlusion pressures improves multisystem function in overweight and obese older women.

This study investigated the effects of 12-week low-intensity blood flow restriction (BFR) training at different arterial occlusion pressure (AOP) levels on cardiopulmonary, immune, muscular, and metabolic functions in overweight and obese older women. A total of 180 community-dwelling women aged ≥ 60 years with body mass index ≥ 25.0 kg/m² were randomly allocated to BFR training groups at 50%, 60%, or 70% AOP or a control group performing identical exercises without pressure. Participants completed supervised training sessions three times weekly for 12 weeks. BFR training induced significant improvements across all physiological systems, with dose-dependent responses correlating with AOP levels. The 70% AOP group demonstrated the greatest reductions in inflammatory markers (IL-6: -28.4%; hs-CRP: -35.7%), the largest gains in muscle hypertrophy (quadriceps thickness: +10.2%), and the most pronounced improvements in metabolic parameters (HOMA-IR: -25.0%). Obese women showed greater absolute improvements in inflammatory and metabolic markers compared to overweight participants. Most improvements were maintained at 24-week follow-up, particularly anti-inflammatory effects in the higher pressure group. The findings establish 60-70% AOP as the optimal range for maximizing multi-system adaptations while maintaining safety. BFR training represents a safe and effective low-load exercise modality for older women, offering comprehensive physiological benefits with high adherence rates (90.7-93.1%) and a low rate of minor adverse events (12.2%), none requiring medical intervention, with 60% AOP recommended as the optimal starting pressure and 70% AOP for individuals requiring maximal cardiometabolic benefits. These findings have potential implications for populations with treatment-related deconditioning, including cancer survivors, though further investigation is warranted.