Effect of High-Intensity Interval Training on Exercise Capacity, Blood Pressure, and Autonomic Responses in Patients With Hypertension: A Systematic Review and Meta-analysis
Fabrício Olinda de Souza Mesquita, Bruno Bavaresco Gambassi, Márcio de Oliveira Silva, Sérgio Rodrigues Moreira, Victor Ribeiro Neves, Mansueto Gomes Neto, Paulo Adriano Schwingel
Abstract
Context: Despite the well-known positive effects of exercise in hypertensive patients, the best mode of exercise is still under discussion. Objective: A systematic review of the literature, synthesizing data on the effects of high-intensity interval training (HIIT) on peak oxygen consumption (VO 2 peak), blood pressure (BP), cardiac autonomic modulation, and resting heart rate (HR) in patients with hypertension. Data Sources: MEDLINE (via PubMed), CENTRAL, PEDro database, and SciELO (from the earliest date available to December 31, 2020). Study Selection: Randomized controlled trials (RCTs) that evaluated the effects of HIIT in hypertensive patients. Study Design: Systematic review and meta-analysis. Level of Evidence: Level 2. Data Extraction: Mean differences (MDs) with a 95% CI were calculated, and heterogeneity was assessed using the I 2 test. Results: Nine RCTs encompassing 569 patients met the eligibility criteria and were included in the systematic review. Five trials compared supervised HIIT with moderate-intensity continuous training (MICT) and a control; 1 trial compared HIIT with MICT, and 3 compared HIIT with a control. In comparison with MICT, HIIT improved VO 2 peak MD (3.3 mL.kg -1 .min -1 ; 95% CI, 1.4-5.3; N = 130). In comparison with controls, HIIT improved VO 2 peak MD (4.4 mL.kg -1 .min -1 ; 95% CI, 2.5-6.2; N = 162). Conclusion: Despite the low quality of the evidence, HIIT is superior to MICT in improving VO 2 peak in patients with hypertension. HIIT effectively improved VO 2 peak, BP, and resting HR when compared with controls. HIIT appears to be safe only when performed in a supervised manner for stage 1 hypertension patients without associated risk factors.