Key result
Moderate-to-vigorous continuous training led to more clinically meaningful reductions in peak systolic blood pressure than high-intensity interval training in AF patients (43% vs 19%, p=0.029).
Why the study?
It was unknown whether 12 weeks of HIIT or MICT leads to changes in hypertensive responses to exercise in adults with persistent or permanent AF, or whether sex-specific responses exist.
Does 12-weeks of high-intensity interval training or moderate-to-vigorous intensity continuous training reduce hypertensive responses to exercise in adults with persistent or permanent atrial fibrillation?
RCT (n=86)
randomized
Does 12-weeks of high-intensity interval training or moderate-to-vigorous intensity continuous training reduce hypertensive responses to exercise in adults with persistent or permanent atrial fibrillation?
Absolute Event Rate: 19% vs 43%
p-value: p=0.029
Both HIIT and MICT may be effective strategies to reduce hypertensive responses to exercise in patients with persistent or permanent atrial fibrillation, with MICT showing a higher proportion of clinically meaningful reductions in peak systolic blood pressure.
MICT may be preferred over HIIT to blunt exercise SBP rise in AF; challenges superiority of high-intensity training in this population.
Abstract Objective To explore whether 12-weeks of high-intensity interval training (HIIT) or moderate-to-vigorous intensity continuous training (MICT) lead to changes in hypertensive responses to exercise (HRE) in adults with persistent or permanent atrial fibrillation (AF). Further, sex-specific responses were explored. Design Non-prespecified post-hoc analysis of a randomized clinical trial. Methods Participants were randomized to a 12-week, twice weekly intervention of either HIIT (2 × 8-min blocks with 30s high-intensity intervals at 80–100% peak power output interspersed with 30-s active recovery; or MICT (60 min of continuous aerobic training at 67–95% heart rate peak). To determine HRE, blood pressure was taken immediately following a six-minute walk test (6MWT) at baseline and 12-weeks post-intervention. HRE was defined as a peak systolic blood pressure (SBPpeak) of ≥170 mmHg. HRE responses relative to fitness (SBPpeak /peak metabolic equivalents [METspeak]) were also calculated. Results Eighty-six participants were randomized to HIIT (n = 43, age: 68 (8) years, 33% female) or MICT (n = 43, age: 71 (7) years, 33% female). A significantly higher proportion of MICT participants had clinically meaningful reductions in SBPpeak (Δ-10 mmHg or more) than HIIT (43% vs 19%, p = 0.029). There was a trend for a small reduction in SBPpeak/METspeak after 12 weeks of aerobic training, with 55% of the cohort having lower SBPpeak/METspeak (baseline: 42 ± 8 mmHg/METs; follow-up: 41 + 14 mmHg/METs; p = 0.0501). Within-sex analyses showed that a higher proportion of females had clinically meaningful reductions in SBPpeak following MICT than HIIT (MICT: 43%; HIIT: 7%). Conclusions Both HIIT and MICT may be effective strategies to reduce HRE in people living with AF and could lead to clinically meaningful reductions. No sex differences were observed for changes in HRE following either HIIT or MICT.
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Way et al. (2026) conducted an RCT in persistent or permanent atrial fibrillation (AF) (n=86). High-intensity interval training (HIIT) vs. Moderate-to-vigorous intensity continuous training (MICT) was evaluated on Clinically meaningful reductions in peak systolic blood pressure (SBPpeak) (Δ-10 mmHg or more) (p=0.029). Moderate-to-vigorous continuous training led to more clinically meaningful reductions in peak systolic blood pressure than high-intensity interval training in AF patients (43% vs 19%, p=0.029).
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