Effects of High-Intensity Interval Training vs Moderate-Intensity Continuous Training on Body Composition and Blood Biomarkers in Coronary Artery Disease Patients: A Randomized Controlled Trial

Catarina Gonçalves^1,2,*, Armando Raimundo^1,2, Ana Abreu³, João Pais⁴, Jorge Bravo^1,2

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¹ Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7000-727 Évora, Portugal

² Comprehensive Health Research Centre, 7002 - 554 Évora, Portugal

³ Department of Cardiology, Santa Maria Hospital, 1649-028 Lisbon, Portugal

⁴ Department of Cardiology, Espírito Santo Hospital of Évora, 7000-811 Évora, Portugal

^*Correspondence: cjg@uevora.pt (Catarina Gonçalves)

Rev. Cardiovasc. Med. 2024, 25(3), 102; https://doi.org/10.31083/j.rcm2503102

Submitted: 28 August 2023 | Revised: 18 October 2023 | Accepted: 27 October 2023 | Published: 11 March 2024

(This article belongs to the Special Issue Current Role and Future Perspectives of Cardiac Rehabilitation in Heart Disease)

This is an open access article under the CC BY 4.0 license.

Abstract

Background: Cardiac rehabilitation (CR) is essential in reducing cardiovascular mortality and morbidity. High-intensity interval training (HIIT) has emerged as a promising exercise intervention for enhancing clinical outcomes in cardiac patients. This study aimed to investigate the effects of two short-term exercise-based programs employing HIIT and moderate-intensity continuous training (MICT) in comparison to a control group concerning blood pressure, body composition, and blood biomarkers in patients diagnosed with coronary artery disease (CAD). Methods: Seventy-two CAD patients (14% women) underwent randomization into three groups: HIIT, MICT, and control. The training programs encompassed six weeks of supervised treadmill exercises, conducted thrice weekly. MICT targeted $\approx$ 70–75% of peak heart rate (HRpeak), while HIIT was tailored to $\approx$ 85–95% of HRpeak. The control group received guidance on adopting healthy lifestyles. Outcome measurements included evaluations of blood pressure, body composition, and blood biomarkers. Results: In contrast to MICT, the HIIT exhibited superior improvements in body fat mass ( $\Delta{}$ %HIIT: 4.5%, p $<$ 0.001 vs. $\Delta{}$ %MICT: 3.2%, p $<$ 0.001), waist circumference ( $\Delta{}$ %HIIT: 4.1%, p = 0.002 vs. $\Delta{}$ %MICT: 2.5%, p = 0.002), hemoglobin A1c (HbA1c) ( $\Delta{}$ %HIIT: 10.4%, p $<$ 0.001 vs. $\Delta{}$ %MICT: 32.3%, p $<$ 0.001) and thyrotropin (TSH) ( $\Delta{}$ %HIIT: 16.5%, p = 0.007 vs. $\Delta{}$ %MICT: 3.1%, p = 0.201). Both HIIT and MICT induced significant enhancements across all variables compared to the control group. Conclusions: HIIT and MICT emerged as effective modalities for enhancing systolic and diastolic function, body composition, and blood biomarkers in CAD patients, with HIIT demonstrating incremental improvements over MICT. The absence of participation in exercise-based programs following cardiovascular events yielded less favorable outcomes. HIIT holds promise as an adjunct intervention in CR programs for CAD patients. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT03538119.

Keywords

cardiovascular disease

cardiovascular risk factors

clinical trials

high-intensity interval training

randomized controlled trial

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Funding

UIDB/04923/2020/National funds through the Foundation for Science and Technology

SFRH/BD/138326/2018/Doctoral fellowship

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Rev. Cardiovasc. Med. Print ISSN 1530-6550 Electronic ISSN 2153-8174