High-intensity interval training in patients with lifestyle-induced cardiometabolic disease: a systematic review and meta-analysis
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Background/Aim: Cardiorespiratory fitness (CRF) is a strong determinant of morbidity and mortality. In athletes and the general population, it is established that high-intensity interval training (HIIT) is superior to moderate-intensity continuous training (MICT) in improving CRF. This is a systematic review and meta-analysis to quantify the efficacy and safety of HIIT compared to MICT in individuals with chronic cardiometabolic lifestyle diseases. Methods: The included studies were required to have a population sample of chronic disease, where poor lifestyle is considered as a main contributor to the disease. The procedural quality of the studies was assessed by use of a modified Physiotherapy Evidence Base Database (PEDro) scale. A meta-analysis compared the mean difference (MD) of preintervention versus postintervention CRF (VO 2 peak) between HIIT and MICT. Results: 10 studies with 273 patients were included in the meta-analysis. Participants had coronary artery disease, heart failure, hypertension, metabolic syndrome and obesity. There was a significantly higher increase in the VO 2 peak after HIIT compared to MICT (MD 3.03 mL/kg/min, 95% CI 2.00 to 4.07), equivalent to 9.1%. Conclusions: HIIT significantly increases CRF by almost double that of MICT in patients with lifestyle-induced chronic diseases.
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The small number of studies synthesized and the specificity of the target populations in prior systematic reviews hinder the generalizability of results to a broader population of individuals who are insufficiently active or present with varying medical conditions.
“The small number of studies synthesized and the specificity of the target populations in these systematic reviews hinder the generalizability of results to a broader population of individuals who are insufficiently active or present with varying medical conditions.”
From Rates of compliance and adherence to high-intensity interval training: a systematic review and Meta-analyses (2023) · cites this paper as [14]
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Experimental — accuracy not yet measuredWeston and colleagues reported attendance rates greater than 85% for six studies focusing on individuals with cardiometabolic disease.
“Weston and colleagues [14] reporting attendance rates > 85% for six studies focusing on individuals with cardiometabolic disease”
From Rates of compliance and adherence to high-intensity interval training: a systematic review and Meta-analyses (2023) · cites this paper as [14]
Both HIIT and MICT exercise modalities have been shown to elicit positive physiological benefits.
“Given that both exercise modalities have been shown to elicit positive physiological benefits [14–18]”
From Rates of compliance and adherence to high-intensity interval training: a systematic review and Meta-analyses (2023) · cites this paper as [14]
A meta-analysis comparing psychological responses to HIIT versus MICT supports the notion that individual responses vary, with many older adults experiencing greater psychological benefits from HIIT.
“Additionally, a meta-analysis comparing psychological responses to HIIT versus moderate-intensity continuous training (MICT) supports the notion that individual responses vary, with many older adults experiencing greater psychological benefits from HIIT [183].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [183]
A meta-analysis comparing psychological responses to HIIT versus moderate-intensity continuous training (MICT) supports the notion that individual responses vary, with many older adults experiencing greater psychological benefits from HIIT.
“Additionally, a meta-analysis comparing psychological responses to HIIT versus moderate-intensity continuous training (MICT) supports the notion that individual responses vary, with many older adults experiencing greater psychological benefits from HIIT [183].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [183]
The increase in VO2peak following 12-16 weeks of supervised HIIT is approximately double the increase seen following MICT.
“A recent meta-analyses reported that the increase in VO2peak following 12–16 weeks of supervised HIIT is approximately double the increase seen following MICT [17].”
From High-Intensity Interval Training as an Efficacious Alternative to Moderate-Intensity Continuous Training for Adults with Prediabetes (2015) · cites this paper as [17]
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- Authors
- Weston, K. S., Wisløff, U., & Coombes, J. S.
- Affiliations
- The University of Queensland (AU)
- Norwegian University of Science and Technology (NO)
- Corresponding author
- Coombes, Jeff S
- Venue
- British Journal of Sports Medicine
- Publisher
- BMJ
- Published
- 2013-10-21
- Volume
- 48
- Issue
- 16
- Pages
- 1227-1234
- ISSN
- 0306-3674 (ISSN-L)
- 1473-0480
- OpenAlex
- W2166758089
- Cited by
- 1,274
- References
- 56
- Citations by year
- 2026: 90 · 2025: 94 · 2024: 98 · 2023: 108 · 2022: 128 · 2021: 131 · 2020: 133 · 2019: 128 · 2018: 128 · 2017: 80 · 2016: 61 · 2015: 61 · 2014: 29 · 2013: 2
- FWCI
- 12.23
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- British Journal of Sports Medicine (publishedVersion)
- PubMed (publishedVersion)
- Research Bank (Australian Catholic University) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
- Keywords
- high-intensity interval training, moderate-intensity continuous training, cardiorespiratory fitness, peak oxygen uptake, cardiometabolic disease, coronary artery disease, heart failure, hypertension, metabolic syndrome, obesity, exercise safety
- MeSH terms
- Cardiac Rehabilitation, Antioxidants, Chronic Disease, Exercise Therapy, Humans, Life Style, Metabolic Diseases, Oxygen Consumption, Patient Compliance, Quality of Life, Risk Factors, Treatment Outcome
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