High‐Intensity Interval Training for Patients With Cardiovascular Disease—Is It Safe? A Systematic Review

Abstract

Background Cardiac rehabilitation ( CR ) for patients with cardiovascular disease has traditionally involved low‐ to moderate‐intensity continuous aerobic exercise training ( MICT ). There is growing and robust evidence that high‐intensity interval training ( HIIT ) shows similar or greater efficacy compared with MICT across a range of cardiovascular and metabolic measures, in both healthy populations and populations with a chronic illness. However, there is understandable concern about the safety aspects of applying HIIT in CR settings. This systematic review analyzed safety data drawn from recent proof‐of‐concept studies of HIIT during CR among patients with cardiovascular disease. Methods and Results We included trials comparing HIIT with either MICT or usual care in patients with coronary artery disease or heart failure participating in tertiary care services, such as phase 2 (outpatient) CR . Adverse events occurring during or up to 4 hours after an exercise training session were collated. There were 23 studies included, which analyzed 1117 participants ( HIIT =547; MICT =570). One major cardiovascular adverse event occurred in relation to an HIIT session, equating to 1 major cardiovascular event per 17 083 training sessions (11 333 training hours). One minor cardiovascular adverse events and 3 noncardiovascular adverse events (primarily musculoskeletal complaints) were also reported for HIIT . Two noncardiovascular events were reported in relation to MICT . Conclusions HIIT has shown a relatively low rate of major adverse cardiovascular events for patients with coronary artery disease or heart failure when applied within CR settings.

Cardiac rehabilitation in the paediatric Fontan population: development of a home-based high-intensity interval training programme

“…12 To this end, in numerous paediatric 11,13 and adult populations, [14][15][16] high-intensity interval training has yielded equivalent or better increases in exercise capacity compared to moderateintensity continuous exercise, while remaining safe and well tolerated in youth 11,13 and adults. [14][15][16] Moreover, high-intensity interval training does not appear to impair systolic or diastolic function in individuals with heart failure; rather, systolic and diastolic function are improved in the immediate post-exercise period. 21 While the safety of high-intensity interval regimens have not been studied in the Fontan population, other exercise interventions in this group have consistently been shown to be safe and well tolerated, with no direct major adverse events being reported to date.…”

“…It repeatedly brings the individual close to or at their peak workload, promoting superior training adaptations. 12 To this end, in numerous paediatric 11,13 and adult populations, [14][15][16] high-intensity interval training has yielded equivalent or better increases in exercise capacity compared to moderate-intensity continuous exercise, while remaining safe and well tolerated. To date, high-intensity interval training has not been evaluated in the single-ventricle population, or any CHD population for that matter.…”

Vigorous cool room treadmill training to improve walking ability in people with multiple sclerosis who use ambulatory assistive devices: a feasibility study

“…Eight of the ten participants completed the training, with attendance rates ranging from 80 to 100%. The attendance rate for high intensity aerobic training has been reported to be comparable among individuals with cardiovascular diseases (87%) [74], chronic stroke (85%) [75], and breast cancer (83%) [76]. In order to characterize exercise-induced changes during training [77], we measured physiological responses across training days (Fig.…”

Preventive Cardio-Oncology: The Time Has Come

“…HIIT provides more effective and efficient regimens than typical exercise programs, at all stages of prevention (104). HIIT has been shown to improve cardiovascular health components such as fitness (110,111), body fat percentage (111,112), waist circumference (112), insulin resistance (111), blood glucose levels (113), blood pressure (113), and lipids (111,112) in the general population, as well as those with a history of cardiac disease (114,115) and in patients with a history of cancer (116). Thus, HIIT should play role in Cardio-Oncology prehabilitation, habilitation, and rehabilitation.…”