Effects of Short-term High-intensity vs. Moderate-intensity Interval Training on Cardiopulmonary Fitness and Metabolic Health in Overweight or Obese Patients with Cardiovascular Disease: Evidence from China.

Abstract

Overweight or obese patients with cardiovascular disease (CVD) often exhibit reduced cardiopulmonary fitness and increased cardiometabolic risk. This study aimed to compare the effects of 4-week supervised high-intensity interval training (HIIT) versus moderate-intensity interval training (MIIT) on exercise capacity and metabolic health in this population. Retrospective study. A tertiary care hospital. One hundred forty-five overweight or obese patients with CVD who completed 12 supervised exercise sessions between 2021 and 2024 were included, including 63 who engaged in HIIT and 82 in MIIT. Both groups completed 12 sessions of structured aerobic interval training. The MIIT group performed moderate-intensity intervals at 40% - 55% of peak power, while the HIIT group performed high-intensity intervals at 80% - 90% of peak power. Cardiopulmonary exercise testing (CPET), body mass index (BMI), waist and hip circumference, and metabolic biomarkers were assessed before and after the rehabilitation programs. Both HIIT and MIIT significantly improved exercise workload time, peak oxygen uptake (peak VO₂), BMI, waist circumference, metabolic syndrome (MetS) z-score, and MetS components (all p < 0.05). Compared with MIIT, HIIT induced a greater increase in exercise workload time, with no other between-group differences in the remaining outcomes after Benjamini-Hochberg correction. In exploratory analyses, improvements in peak VO₂ were positively correlated with reductions in body weight and BMI within the HIIT group. Short-term structured aerobic exercise, including HIIT and MIIT, improves cardiopulmonary fitness and metabolic health, supporting its integration into cardiac rehabilitation programs for overweight or obese patients with CVD.