The Evidence for High Intensity Interval Training for Patients with CAD

About this course

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Exercise-based cardiac rehabilitation is integral to secondary prevention in patients with coronary artery disease. Recently, the effectiveness and “superiority” of high-intensity interval training (HIIT) is a purported time-saving alternative to “traditional” moderate-intensity continuous training (MICT) in cardiac rehabilitation. The rationale for HIIT adoption is, however, not fully substantiated in the scientific literature. Established guidelines for exercise testing and training, when carefully adhered to, reduce the likelihood of triggering a cardiac event or inducing musculoskeletal injury. Clinicians should likewise consider patient risk stratification and introduce HIIT as an alternative to MICT only after patients exhibit stable and asymptomatic responses to vigorous exercise training. Although HIIT adherence appears comparable with MICT during outpatient rehabilitation, compliance drops dramatically for unsupervised exercise. Despite the enthusiasm surrounding HIIT, its main advantage over MICT appears to be short-term exercise performance outcomes and indices of vascular function. Regarding benefits to cardiovascular disease risk factor modification, management of vital signs, and measures of cardiac performance, current evidence indicates that HIIT does not outperform MICT. Long-term outcomes to HIIT are currently uncertain and logistical constraints to HIIT incorporation need additional clarification. Based on these limited findings, derived from facilities and clinicians at the forefront of cardiac rehabilitation, the routine adoption of HIIT should be viewed cautiously. In conclusion, the current review highlights numerous specific research directives that are needed before the safety and effectiveness of HIIT can be confirmed and widely adopted in patients with known or suspected coronary artery disease, especially in unsupervised, nonmedical settings.

What you will learn

• To understand what evidence does and does not exist regarding the efficacy of HIIT training for persons with CAD
• To understand what evidence exists for HIIT exercise training low/moderate/high risk patients based on AACVPR criteria
• To understand the outcomes of HIIT training relative to key dependent outcome variables for exercise capacity, disease risk factor modification, cardiac performance, disease recurrance/prevention, and for incidence of depression and anxiety
• To understand how HIIT training efficacy in cardiac populations relative to the number of observable hours needed to confirm/refute whether this type of exercise precipitates untoward cardiac events
• To understand what evidence exists for HIIT versus MICT within the context of quasi-experimental designed clinical trials as compared to fully experimental designed clinical trials

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