Supervisors info:
Αναστάσιος Φιλίππου, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Μαρία Μαριδάκη, Αναπληρώτρια Καθηγήτρια, Τμήμα Επιστήμης Φυσικής Αγωγής και Αθλητισμού, ΕΚΠΑ
Μιχαήλ Κουτσιλιέρης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Summary:
Coronary Heart Disease (CHD) is the most common cause of death worldwide, as 1 out of 4 deaths in 2016 were linked with CHD, according to the World Health Organization (WHO). The pathophysiology of the disease involves atheromatous plaque formation inside the vessel and blood flow reduction to the heart muscle, that finally leads to myocardial ischemia. Cardiovascular risk factors such as blood pressure, smoking, high levels of blood glucose and cholesterol and chronic inflammation contribute to the manifestation of CHD. In addition, lack of exercise and poor diet have been shown to increase the risk of a cardiovascular event. On the contrary, aerobic exercise during cardiac rehabilitation, has been proven to offer various health benefits, by reducing cardiovascular risk factors and improving cardiovascular function after myocardial infarction. Despite the undisputed benefits of aerobic exercise, High Intensity Interval Training (HIIT) and its possible benefit for CHD patients has also drawn the scientific community’s attention over the last years. In this review, the term HIIT and its application in cardiac rehabilitation as a complementary therapy for CHD are analyzed. Furthermore, it’s effects on important variables such as peak aerobic capacity (VO2 peak), endothelial function, inflammation and cardiovascular risk factors are evaluated. According to the literature, HIIT is highly effective at improving cardiorespiraratory capacity, endothelial function and reducing inflammation. Conversely, research findings regarding the effect of HIIT on blood pressure, blood glucose and cholesterol levels are unclear, as some controlled trials reported a decrease in these markers, while others didn’t find any statistically significant difference. Scientific data on the patients’ safety and adherence to HIIT are also presented. Research has shown that HIIT is safe for stable and physically fit patients, as the risk of a cardiovascular event is low. Furthermore, patients seem to prefer HIIT over aerobic exercise, resulting in improved long-term adherence. Lastly, the basic principles of exercise prescription are elaborated through the presentation of different HIIT protocols, based on the patient’s individual characteristics and needs. In conclusion, HIIT is an effective, safe exercise alternative for stable CHD patients. Thus, targeted implementation of HIIT is feasible. Nevertheless, additional research is required, with the participation of older, less physically fit patients in systematic controlled trials, before HIIT can be widely applied in cardiac rehabilitation settings.
Keywords:
High Intensity Interval Training, HIIT, Coronary Heart Disease, CHD, Cardiac rehabilitation, VO2 peak, Prescription
