The relationship between post-occlusive reactive hyperemia and the level of training and lifestyle in young adults.

BACKGROUND: Post-occlusive reactive hyperemia (PORH) is widely used to assess microvascular function. Increasing attention has been directed toward temporal characteristics of the PORH response and the need for individualized arterial occlusion pressure (AOP); however, comparative data across athletes with different training profiles and non-athletic controls remain limited. PURPOSE: To compare PORH-derived microcirculatory parameters among individuals with different training backgrounds using an individualized AOP approach. METHODS: This cross-sectional study included 60 participants (n = 60, 50 males and 10 females) divided into four groups (n = 15 each): marathon runners, bodybuilders, mixed martial arts (MMA) athletes, and non-athletic controls. PORH was assessed using laser Doppler flowmetry (LDF). The analyzed parameters included resting flow (RF), biological zero (BZ), maximum peak perfusion (MAX Peak), time to peak perfusion (TP), and time to recovery (TTR). Between-group comparisons were performed using the Kruskal-Wallis test with post-hoc analysis, and effect size was calculated (ε2). RESULTS: The Kruskal-Wallis test revealed a significant between-group difference only for TP (H = 18.914; p = 0.0003; ε2 = 0.28). MMA athletes exhibited a significantly shorter TP (20.6 ± 3.0 s) compared with marathon runners (47.5 ± 36.1 s), bodybuilders (42.9 ± 21.4 s), and the general population (37.9 ± 15.9 s). No significant differences were observed for RF, BZ, MAX Peak, or TTR (all p > 0.05). CONCLUSIONS: Time to peak perfusion is a sensitive parameter distinguishing microvascular responses across training profiles. A shorter time to peak perfusion (TP) is generally interpreted as a more efficient microvascular response and improved vascular reactivity. MMA athletes demonstrate a faster microvascular response following occlusion, likely reflecting training-specific vascular adaptations associated with mixed, high-intensity exercise. These findings highlight the importance of AOP individualization and the use of temporal PORH parameters in microcirculatory assessment of athletes.