The use of high-intensity interval training (HIIT) in cardiac rehabilitation - a review
DOI:
https://doi.org/10.12775/QS.2025.48.67327Keywords
high-intensity interval training, cardiac rehabilitation, coronary artery disease, myocardial infarction, heart failure, exercise therapyAbstract
Background. Cardiac rehabilitation plays a crucial role in reducing mortality and improving the quality of life in patients after cardiovascular events. High-intensity interval training (HIIT) is gaining attention as a time-efficient and potentially more effective alternative to moderate-intensity continuous training (MICT).
Aim. The aim of this review is to assess the effectiveness and the safety of high-intensity interval training in cardiac rehabilitation.
Material and methods. A literature search was performed using PubMed database, narrowing it down to studies published between 2015 and 2025. The inclusion criteria focused on the use of high-intensity interval training in patients with coronary artery disease, after myocardial infarction, and with heart failure.
Results. The analyzed studies demonstrated that high-intensity interval training significantly improves cardiorespiratory fitness, endothelial function, and metabolic parameters. Recent meta-analyses confirm the effectiveness of HIIT showing a significantly greater increase in peak oxygen uptake (VO₂ peak), with an average difference of approximately 1.42 mL/kg/min, compared to MICT. When patients are properly selected and monitored, HIIT is safe and well tolerated in cardiac rehabilitation programs.
Conclusions. HIIT is an effective and safe form of exercise for cardiac patients and may complement or even replace traditional training approaches. However, it requires individualized programming and supervision by a specialized medical team. Further research is necessary to confirm its long-term outcomes.
References
[1] WHO, “cardiovascular diseases.” [Online]. Available: https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
[2] S. S. Martin et al., “2025 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association,” Circulation, vol. 151, no. 8, Feb. 2025, doi: 10.1161/cir.0000000000001303. https://doi.org/10.1161/CIR.000000000000130
[3] G. O. Dibben et al., “Exercise-based cardiac rehabilitation for coronary heart disease: a meta-analysis,” European Heart Journal, vol. 44, no. 6, pp. 452–469, Feb. 2023, doi: 10.1093/eurheartj/ehac747. https://doi.org/10.1093/eurheartj/ehac747
[4] P. Myneni et al., “Effectiveness of Cardiac Rehabilitation in Enhancing Clinical Outcomes for Coronary Artery Disease: A Systematic Analysis,” Cureus, Sept. 2024, doi: 10.7759/cureus.69224. Available: https://www.cureus.com/articles/287476-effectiveness-of-cardiac-rehabilitation-in-enhancing-clinical-outcomes-for-coronary-artery-disease-a-systematic-analysis#!/
[5] S. E. Keating, N. A. Johnson, G. I. Mielke, and J. S. Coombes, “A systematic review and meta‐analysis of interval training versus moderate‐intensity continuous training on body adiposity,” Obesity Reviews, vol. 18, no. 8, pp. 943–964, Aug. 2017, doi: 10.1111/obr.12536. https://doi.org/10.1111/obr.12536
[6] F. Gripp et al., “HIIT is superior than MICT on cardiometabolic health during training and detraining,” Eur J Appl Physiol, vol. 121, no. 1, pp. 159–172, Jan. 2021, doi: 10.1007/s00421-020-04502-6. Available:https://link.springer.com/article/10.1007/s00421-020-04502-6
[7] K. L. Way, R. N. Sultana, A. Sabag, M. K. Baker, and N. A. Johnson, “The effect of high Intensity interval training versus moderate intensity continuous training on arterial stiffness and 24 h blood pressure responses: A systematic review and meta-analysis,” Journal of Science and Medicine in Sport, vol. 22, no. 4, pp. 385–391, Apr. 2019, doi: 10.1016/j.jsams.2018.09.228. https://doi.org/10.1016/j.jsams.2018.09.228
[8] J. S. Ramos, L. C. Dalleck, A. E. Tjonna, K. S. Beetham, and J. S. Coombes, “The Impact of High-Intensity Interval Training Versus Moderate-Intensity Continuous Training on Vascular Function: a Systematic Review and Meta-Analysis,” Sports Med, vol. 45, no. 5, pp. 679–692, May 2015, doi: 10.1007/s40279-015-0321-z. Available: https://link.springer.com/article/10.1007/s40279-015-0321-z
[9] J. L. Taylor et al., “Guidelines for the delivery and monitoring of high intensity interval training in clinical populations,” Progress in Cardiovascular Diseases, vol. 62, no. 2, pp. 140–146, Mar. 2019, doi: 10.1016/j.pcad.2019.01.004. https://doi.org/10.1016/j.pcad.2019.01.004
[10] B. K. Pedersen and B. Saltin, “Exercise as medicine – evidence for prescribing exercise as therapy in 26 different chronic diseases,” Scandinavian Med Sci Sports, vol. 25, no. S3, pp. 1–72, Dec. 2015, doi: 10.1111/sms.12581. https://doi.org/10.1111/sms.12581
[11] J. L. Reed et al., “The effects of high-intensity interval training, Nordic walking and moderate-to-vigorous intensity continuous training on functional capacity, depression and quality of life in patients with coronary artery disease enrolled in cardiac rehabilitation: A randomized controlled trial (CRX study),” Progress in Cardiovascular Diseases, vol. 70, pp. 73–83, Jan. 2022, doi: 10.1016/j.pcad.2021.07.002. https://doi.org/10.1016/j.pcad.2021.07.002
[12] Y. Yang et al., “Effects of high-intensity interval training on cardiorespiratory function in coronary artery disease: An overview of systematic reviews,” Annals of Physical and Rehabilitation Medicine, vol. 68, no. 2, p. 101878, Mar. 2025, doi: 10.1016/j.rehab.2024.101878. https://doi.org/10.1016/j.rehab.2024.101878
[13] Y. Dun, J. R. Smith, S. Liu, and T. P. Olson, “High-Intensity Interval Training in Cardiac Rehabilitation,” Clinics in Geriatric Medicine, vol. 35, no. 4, pp. 469–487, Nov. 2019, doi: 10.1016/j.cger.2019.07.011. https://doi.org/10.1016/j.cger.2019.07.011
[14] C. Gao, Y. Yue, D. Wu, J. Zhang, and S. Zhu, “Effects of high-intensity interval training versus moderate-intensity continuous training on cardiorespiratory and exercise capacity in patients with coronary artery disease: A systematic review and meta-analysis,” PLoS ONE, vol. 20, no. 2, p. e0314134, Feb. 2025, doi: 10.1371/journal.pone.0314134. https://doi.org/10.1371/journal.pone.0314134
[15] Z. Milanović, G. Sporiš, and M. Weston, “Effectiveness of High-Intensity Interval Training (HIT) and Continuous Endurance Training for VO2max Improvements: A Systematic Review and Meta-Analysis of Controlled Trials,” Sports Medicine, vol. 45, no. 10, pp. 1469–1481, Oct. 2015, doi: 10.1007/s40279-015-0365-0. Available: https://link.springer.com/article/10.1007/s40279-015-0365-0
[16] A. Hannan et al., “Australian cardiac rehabilitation exercise parameter characteristics and perceptions of high-intensity interval training: a cross-sectional survey,” OAJSM, vol. Volume 9, pp. 79–89, Apr. 2018, doi: 10.2147/oajsm.s160306. https://doi.org/10.2147/OAJSM.S160306
[17] M. Taya et al., “High-intensity aerobic interval training can lead to improvement in skeletal muscle power among in-hospital patients with advanced heart failure,” Heart Vessels, vol. 33, no. 7, pp. 752–759, July 2018, doi: 10.1007/s00380-018-1120-x. Available: https://link.springer.com/article/10.1007/s00380-018-1120-x
[18] S. Li, X. Chen, H. Jiao, Y. Li, G. Pan, and X. Yitao, “The Effect of High-Intensity Interval Training on Exercise Capacity in Patients with Coronary Artery Disease: A Systematic Review and Meta-Analysis,” Cardiology Research and Practice, vol. 2023, pp. 1–11, Apr. 2023, doi: 10.1155/2023/7630594. https://doi.org/10.1155/2023/7630594
[19] Ø. Ellingsen et al., “High-Intensity Interval Training in Patients With Heart Failure With Reduced Ejection Fraction,” Circulation, vol. 135, no. 9, pp. 839–849, Feb. 2017, doi: 10.1161/circulationaha.116.022924. https://doi.org/10.1161/CIRCULATIONAHA.116.022924
[20] P. Luo, R. Wu, W. Gao, W. Yan, R. Wang, and Y. Ye, “Effects of high-intensity interval exercise on arterial stiffness in individuals at risk for cardiovascular disease: a meta-analysis,” Front. Cardiovasc. Med., vol. 11, Apr. 2024, doi: 10.3389/fcvm.2024.1376861. https://doi.org/10.3389/fcvm.2024.1376861
[21] K. L. Way et al., “Cluster Sets to Prescribe Interval Resistance Training: A Potential Method to Optimise Resistance Training Safety, Feasibility and Efficacy in Cardiac Patients,” Sports Med - Open, vol. 9, no. 1, Sept. 2023, doi: 10.1186/s40798-023-00634-z. Available: https://sportsmedicine-open.springeropen.com/articles/10.1186/s40798-023-00634-z
[22] H. Safiyari-Hafizi, J. Taunton, A. Ignaszewski, and D. E. R. Warburton, “The Health Benefits of a 12-Week Home-Based Interval Training Cardiac Rehabilitation Program in Patients With Heart Failure,” Canadian Journal of Cardiology, vol. 32, no. 4, pp. 561–567, Apr. 2016, doi: 10.1016/j.cjca.2016.01.031. https://doi.org/10.1016/j.cjca.2016.01.031
[23] C. Yang et al., “High intensity interval training vs. moderate intensity continuous training on aerobic capacity and functional capacity in patients with heart failure: a systematic review and meta-analysis,” Front. Cardiovasc. Med., vol. 11, Feb. 2024, doi: 10.3389/fcvm.2024.1302109. https://doi.org/10.3389/fcvm.2024.1302109
[24] Y. Dun et al., “High-Intensity Interval Training in Cardiac Rehabilitation: Impact on Fat Mass in Patients With Myocardial Infarction,” Mayo Clinic Proceedings, vol. 94, no. 9, pp. 1718–1730, Sept. 2019, doi: 10.1016/j.mayocp.2019.04.033. https://doi.org/10.1016/j.mayocp.2019.04.033
[25] I. Okur, C. C. Aksoy, F. Yaman, and T. Sen, “Which high-intensity interval training program is more effective in patients with coronary artery disease?,” International Journal of Rehabilitation Research, vol. 45, no. 2, pp. 168–175, June 2022, doi: 10.1097/mrr.0000000000000524. Available:https://journals.lww.com/intjrehabilres/fulltext/2022/06000/which_high_intensity_interval_training_program_is.9.aspx
[26] L. Fuertes-Kenneally et al., “Effects of high-intensity interval training on vascular function in patients with cardiovascular disease: a systematic review and meta-analysis,” Front. Physiol., vol. 14, July 2023, doi: 10.3389/fphys.2023.1196665. https://doi.org/10.3389/fphys.2023.1196665
[27] M. Okamura, M. Shimizu, S. Yamamoto, K. Nishie, and M. Konishi, “The effectiveness of high-intensity interval training compared to moderate-intensity continuous training in patients with heart failure: a systematic review and meta-analysis,” European Heart Journal, vol. 44, no. Supplement_2, Nov. 2023, doi: 10.1093/eurheartj/ehad655.2897. https://doi.org/10.1093/eurheartj/ehad655.2897
[28] G. McGregor et al., “High-intensity interval training in cardiac rehabilitation: a multi-centre randomized controlled trial,” European Journal of Preventive Cardiology, vol. 30, no. 9, pp. 745–755, July 2023, doi: 10.1093/eurjpc/zwad039. https://doi.org/10.1093/eurjpc/zwad039
[29] A. Keech et al., “High-intensity interval training for patients with coronary artery disease: Finding the optimal balance,” International Journal of Cardiology, vol. 298, pp. 8–14, Jan. 2020, doi: 10.1016/j.ijcard.2019.09.060. https://doi.org/10.1016/j.ijcard.2019.09.060
[30] K. L. Way, S. Vidal-Almela, M.-L. Keast, H. Hans, A. L. Pipe, and J. L. Reed, “The feasibility of implementing high-intensity interval training in cardiac rehabilitation settings: a retrospective analysis,” BMC Sports Sci Med Rehabil, vol. 12, no. 1, Dec. 2020, doi: 10.1186/s13102-020-00186-9. Available:https://bmcsportsscimedrehabil.biomedcentral.com/articles/10.1186/s13102-020-00186-9
[31] C. Kim and H. E. Choi, “The Effect and Safety of Aerobic Interval Training According to Exercise Intensity in Acute Coronary Syndrome,” Journal of Cardiopulmonary Rehabilitation and Prevention, vol. 40, no. 3, pp. 178–182, May 2020, doi: 10.1097/hcr.0000000000000455. Available:https://journals.lww.com/jcrjournal/fulltext/2020/05000/the_effect_and_safety_of_aerobic_interval_training.8.aspx
[32] M. A. Wewege, D. Ahn, J. Yu, K. Liou, and A. Keech, “High‐Intensity Interval Training for Patients With Cardiovascular Disease—Is It Safe? A Systematic Review,” JAHA, vol. 7, no. 21, Nov. 2018, doi: 10.1161/jaha.118.009305. https://doi.org/10.1161/JAHA.118.009305
[33] A. Kumar et al., “Impact of High-Intensity Interval Training (HIIT) on Patient Recovery After Myocardial Infarction and Stroke: A Fast Track to Fitness,” Cureus, Nov. 2024, doi: 10.7759/cureus.73910. Available:https://www.cureus.com/articles/304667-impact-of-high-intensity-interval-training-hiit-on-patient-recovery-after-myocardial-infarction-and-stroke-a-fast-track-to-fitness#!/
[34] L. H. Tang et al., “Patients’ preference for exercise setting and its influence on the health benefits gained from exercise-based cardiac rehabilitation,” International Journal of Cardiology, vol. 232, pp. 33–39, Apr. 2017, doi: 10.1016/j.ijcard.2017.01.126. https://doi.org/10.1016/j.ijcard.2017.01.126
[35] L. S. Lee, L. Banks, P. I. Oh, D. Brooks, and T. J. F. Colella, “Capturing the perspectives of women with coronary artery disease regarding interval training or continuous exercise in cardiac rehabilitation,” Disability and Rehabilitation, vol. 44, no. 1, pp. 68–78, Jan. 2022, doi: 10.1080/09638288.2020.1756469. https://doi.org/10.1080/09638288.2020.1756469
[36] M. Carrasco-Poyatos, R. López-Osca, I. Martínez-González-Moro, and A. Granero-Gallegos, “HRV-guided training vs traditional HIIT training in cardiac rehabilitation: a randomized controlled trial,” GeroScience, vol. 46, no. 2, pp. 2093–2106, Oct. 2023, doi: 10.1007/s11357-023-00951-x. Available:https://link.springer.com/article/10.1007/s11357-023-00951-x
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Magdalena Barczewska, Dominika Bieszczad, Barbara Reizer, Zofia Botto, Marzena Swojnóg, Patrycja Felisiak, Dominika Kowalczyk, Zofia Śliwa, Dominik Andrzej Ślazyk, Klaudia Krystek

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 11
Number of citations: 0