TABLE 1.

Summarizes concerns about the use of BFRT associated with DVT development in medically compromised populations.

Medical condition	Concerns about use of BFRT and DVT
Hypertension	• Patients with hypertension are in a hypercoagulative and potentially prothrombotic state. This increased thrombotic risk has primarily attributed to the endothelial dysfunction associated with hypertension. • Additionally, hypertension frequently presents with elevations in hemostatic factors such as P-selectin (platelet aggregator), fibrinogen, and PAI-1 (Yang et al., 2010).
Post-COVID-19 infection	• Patients with COVID-19 may develop both venous and arterial system coagulopathy caused by endotheliitis, hypercoagulopathy, and stasis (Sarkar et al., 2021).
Pregnancy/Postpartum women	• Pregnancy has been shown to result in elevations in fibrinogen, factor VII, factor VIII, von Willebrand factor, factor IX, factor X, factor XII, and PAI-1 which increases the risk of DVT formation (Prisco et al., 2005). • Other factors such as delivery method (cesarean section) and obesity, multiparity, and medical comorbidities increases the risk for DVT as well (Alsheef et al., 2020). • Following pregnancy, DVT risk is 5 times higher, and acquisition of a pulmonary embolism is 15 times more likely than during pregnancy (Heit et al., 2005). • Increases in pro-coagulant and decreases in anti-coagulants are observed in OCP users compared to non-users (Gunaratne et al., 2021).
Diabetes mellitus	• Patients with DM type 1 or type 2 are at increased risk of DVT due to systemic changes and endothelial dysfunction (Diabetes, 2019). • Hyperglycemia triggers vascular damage by an imbalance between nitric oxide (NO) and reactive oxidative species (ROS), platelet aggregation, inflammation, and increased expression of coagulant tissue factors like PAI-1 (Paneni et al., 2013; Kaur et al., 2018).
Rheumatoid arthritis and Chronic kidney disease	• Rheumatoid arthritis patients are at an elevated risk of VTEs, pulmonary embolisms and DVT formation compared to the general population (Li et al., 2021). • Elevated thrombogenic factors can help explain the excessive risk for CVD, and all appear in a greater proportion of CKD patients than the general populace (Levey et al., 1998).
Post-surgery	• The risk of DVT is increased 100-fold in the first 6 weeks following surgery (Bond et al., 2019) and pulmonary embolism risk is more significant in the 12 weeks following surgery in middle-aged women, which of course, will depend on the type of surgery (Sweetland et al., 2009). • The relative risk for thrombosis after hip and knee arthroplasty is 220 times higher in the first 6 weeks after surgery, 91.6 times higher after cancer surgery, and 87 times higher after vascular surgery highlighting that surgery of any kind increases risk of DVT formation (Sweetland et al., 2009).
Anabolic steroid users and certain ergogenic aids*	• Users have a high risk of suffering from thrombotic complications, cardiomyopathy, stroke, pulmonary embolism, fatal and non-fatal arrythmias, and myocardial infarction (Sculthorpe et al., 2012). • Anabolic steroid users have side effects such as dyslipidemia, polycythemia, hyperhomocystemia, hypercoagulability state, cardiac and vascular hypertrophy, impaired angiogenesis, redox imbalance, and cardiomyocyte apoptosis (Seara et al., 2020).

BFRT, blood flow restriction training; DVT, deep vein thrombosis; VTE, venous thromboembolism; CVD, cardiovascular disease; OCP, oral contraception; PAI-1, plasminogen activator inhibitor-1; CKD, chronic kidney disease. *Anabolic/ergogenic agents are not considered a medically compromised population but exhibit heightened risk for negative vascular sequalae that predispose to DVTs.