Key result
High-intensity interval training modestly reduces cfPWV and improves vascular stiffness versus moderate continuous training or usual care.
Why the study?
Several small randomized trials have examined the effects of HIIT on hemostasis and vascular stiffness, but a clear consensus has not been established.
Does high-intensity interval training (HIIT) improve hemostasis and vascular stiffness in adults with or without cardiovascular disease compared to moderate-intensity continuous training or usual care?
Meta-Analysis (n=2,679)
Does high-intensity interval training (HIIT) improve hemostasis and vascular stiffness in adults with or without cardiovascular disease compared to moderate-intensity continuous training or usual care?
Effect estimate: SMD -0.22 (95% CI -0.38 to -0.06)
p-value: p=0.0019
High-intensity interval training significantly improves fibrinogen levels and measures of vascular stiffness (cfPWV, AIx, FMD) compared to moderate-intensity continuous training or usual care.
Supports HIIT in exercise prescriptions for vascular stiffness; extends meta-analytic evidence on cfPWV and hemostasis.
Background Several small randomized trials have examined the effects of high-intensity interval training (HIIT) on hemostasis and vascular stiffness. However, a clear consensus regarding these effects has not been established. The study is to systematically review the evidence and quantify the impacts of HIIT compared with moderate-intensity continuous training (MICT) or usual care (UC) on hemostasis and vascular stiffness. Methods Randomized controlled trials (RCTs) exploring the impact of HIIT, MICT, or UC on hemostasis and vascular stiffness were retrieved from PubMed, Embase, Web of Science, and Cochrane databases up to June 10, 2025. A meta-analysis was performed to compare the standardized mean differences (SMD) of changes from baseline to post-intervention in platelet count (PLT), fibrinogen (FIB), D-dimer (D-D), carotid-femoral pulse wave velocity (cfPWV), augmentation index (AIx), AIx normalized to a heart rate of 75 beats·min −1 (AIx@75HR), flow-mediated dilation (FMD), and brachial flow-mediated dilation normalized (nFMD), which were used to evaluate hemostasis and vascular stiffness. The 95% confidence interval (95% CI) was calculated along with the SMD. All analyses were conducted in R (version 4.3.3). Results Overall, 68 RCTs involving 2,679 patients were included in the analysis. PLT [SMD (95% CI) = −0.26 (−0.51; −0.01)] and FIB [SMD (95% CI) = −0.60 (−1.18; −0.01)] in hemostasis were decreased. Decreased cfPWV [SMD (95% CI) = −0.22 (−0.38; −0.06)], AIx [SMD (95% CI) = −0.16 (−0.30; −0.02)], and AIx@75HR [SMD (95% CI) = −0.35 (−0.61; −0.10)], as well as increased FMD [SMD (95% CI) = 0.37 (0.02; 0.72)] were observed in vascular stiffness. However, there were no notable differences in the D-D and nFMD parameters. Conclusion HIIT notably improved FIB, cfPWV, AIx, and FMD compared to MICT, or UC. Under certain conditions, PLT and AIx@75HR can also benefit from HIIT. It may be particularly advantageous for patients with cardiovascular disease. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/view/522614 , identifier CRD42024522614.
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Jiao et al. (2025) conducted a meta-analysis in Cardiovascular disease and non-cardiovascular disease (n=2,679). High-intensity interval training (HIIT) vs. Moderate-intensity continuous training (MICT) or usual care (UC) was evaluated on Carotid-femoral pulse wave velocity (cfPWV) (SMD -0.22, 95% CI -0.38 to -0.06, p=0.0019). High-intensity interval training significantly decreased carotid-femoral pulse wave velocity (SMD -0.22) and improved other markers of hemostasis and vascular stiffness compared to moderate-intensity continuous training or usual care.
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