High-intensity resistance training is effective in improving muscle strength but poses a higher risk of atherosclerosis. Combining high-intensity resistance training with aerobic exercise can reduce atherosclerosis levels. Low-intensity resistance training combined with blood flow restriction does not require high-load force to stimulate muscles and may improve muscle strength and maintain arterial elasticity. The objective of the study was to investigate the effects of 12 weeks of low-intensity resistance training combined with blood flow restriction on body composition, muscle strength, and arterial elasticity in young people. The primary aim is to clarify whether the low-intensity resistance training combined with blood flow restriction training is a scientific training method to improve muscle strength and maintain arterial elasticity, and providing theoretical support for the scientific implementation of blood flow restriction training and the development of individualized training programs. Fifty-five college students were randomly divided into three groups: high-intensity resistance training, high-intensity resistance training combined with aerobic exercise, and low-intensity resistance training combined with blood flow restriction. Each group underwent 12 weeks of their respective training programs, and the effects on body composition, muscle strength, and arterial elasticity were examined. After 12 weeks, lean body mass significantly increased in both the high-intensity resistance training and low-intensity resistance training combined with blood flow restriction groups (P < 0.05). 1RM and knee isometric muscle strength significantly increased in all three groups (P < 0.05). Arterial elasticity significantly improved in both the high-intensity resistance training combined with aerobic exercise group and the low-intensity resistance training combined with blood flow restriction group (P < 0.05). Twelve weeks of high-intensity resistance training and low-intensity resistance training combined with blood flow restriction significantly improved body composition. All three training methods increased muscle strength. Low-intensity resistance training combined with blood flow restriction was more effective in improving arterial elasticity than high-intensity resistance training combined with aerobic exercise. Therefore, low-intensity resistance training combined with blood flow restriction is recommended as the preferred method to improve body composition, muscle strength, and arterial elasticity, reducing the risk of atherosclerosis.

• Both high-intensity resistance training (HIRT) and low-intensity resistance training combined with blood flow restriction (LIR-BFRT) significantly improved lean body mass after 12 weeks.

• No significant changes were observed in fat mass across the groups, suggesting that the primary impact was on muscle mass rather than fat reduction.

• All three training protocols (HIRT, HIR-AET, and LIR-BFRT) resulted in significant increases in 1RM (one-repetition maximum) and knee isometric muscle strength.

• LIR-BFRT and HIR-AET (high-intensity resistance training combined with aerobic exercise) were more effective in improving arterial elasticity compared to HIRT alone.

• The combination of low-intensity resistance with blood flow restriction provides a safer alternative to high-intensity training in terms of cardiovascular health.