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Patients with HFpEF exhibit a diminished pressor response to exercise, potentially due to a muted muscle metaboreflex. This highlights the consequences of impaired neural cardiovascular control during exercise in this patient population. Moderate acute intermittent hypoxia (mAIH) induces the spinal respiratory motor adaptation, phrenic long-term facilitation (pLTF), a critical physiological response. Middle-aged male and geriatric femal