# High-resistance inspiratory muscle strength training: a promising strategy for improving vascular health in chronic kidney disease

## TL;DR

This paper suggests that high-resistance inspiratory muscle training may improve vascular health in chronic kidney disease patients, who are at high risk for cardiovascular disease.

## Contribution

The paper introduces high-resistance inspiratory muscle strength training as a novel, non-pharmacological intervention for vascular health in CKD.

## Key findings

- CKD patients have accelerated vascular aging and increased CVD risk despite drug treatment.
- High-resistance inspiratory muscle strength training may overcome exercise barriers in CKD patients.
- This training could rescue vascular health and reduce CVD development in CKD.

## Abstract

Patients with chronic kidney disease (CKD) demonstrate accelerated vascular aging which contributes to an increased risk of cardiovascular disease (CVD). Impaired vascular health in CKD is characterized by both functional and structural alterations to the vasculature including hypertension, arterial stiffness, vascular endothelial dysfunction, and autonomic dysfunction. These detriments persist despite pharmacological intervention. Habitual aerobic exercise can be protective of vascular health; however, the feasibility in patients with CKD is low due to numerous barriers to exercise. In this perspective we emphasize the need for novel and non-pharmacological strategies that can rescue vascular health and reduce the development of CVD in patients with CKD, explain the unique barriers to aerobic exercise in CKD, present a novel physical training intervention—high-resistance inspiratory muscle strength training (IMST) that addresses the barriers to exercise, and provide our opinion on why this lifestyle intervention may be particularly efficacious for patients with CKD.