Download PDF
CC BY-NC-ND 4.0 · Sports Med Int Open 2025; 09: a24939466
DOI: 10.1055/a-2493-9466
Training & Testing

High Intensity Interval Training and Arterial Hypertension: Quality of Reporting

Claudia Bünzen
1   Institute of Sport Science, Kiel University, Kiel, Germany
,
Kaija Oberbeck
1   Institute of Sport Science, Kiel University, Kiel, Germany
,
Sascha Ketelhut
2   Institute of Sports Science, University of Bern, Bern, Switzerland
,
Burkhard Weisser
1   Institute of Sport Science, Kiel University, Kiel, Germany
› Author Affiliations Funding Information Land Schleswig-Holstein/funding programme Open Access Publikationsfonds
› Further Information
Also available at
   Permissions and Reprints

Abstract

The benefits of exercise have been well described for the treatment of hypertension. Poor reporting quality impairs quality appraisal and replicability. High intensity interval training (HIIT) has been shown to be an effective alternative to traditional aerobic exercise in patients with hypertension. We evaluated the completeness of reporting of randomized controlled trials (RCTs) with HIIT for hypertension and to compare both exercise modes in reporting quality. RCTs of HIIT with a minimum duration of 6 weeks in adults with at least high normal blood pressure (≥130 mmHg/≥85 mmHg) were evaluated using the Consensus on Exercise Reporting Template (CERT). Nine RCTs conducting HIIT in hypertensive patients (N=718; 51.8 years) were evaluated. A mean of 62.6% of items were sufficiently described, compared with 49.2% in moderate intensity training interventions. Exercise dose was adequately reported in 8 out of 9 studies. Only one study reported information on adverse events. In a small sample of RCTs with HIIT in patients with hypertension we found a better reporting quality than in moderate intensity training interventions. However, reporting completeness is not optimal for a good replicability in clinical practice. The lack of reporting of adverse events in interventions using high intensities is particularly unfavourable.

Keywords

reporting quality - clinical practice - CERT checklist - interval training - high blood pressure

Supplementary Material



Publication History

Received: 11 September 2024
Received: 04 November 2024

Accepted: 10 November 2024

Article published online:
12 February 2025

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

Bibliographical Record
Claudia Bünzen, Kaija Oberbeck, Sascha Ketelhut, Burkhard Weisser. High Intensity Interval Training and Arterial Hypertension: Quality of Reporting. Sports Med Int Open 2025; 09: a24939466.
DOI: 10.1055/a-2493-9466
 

  • References

  • 1 World Health Organization. Global report on hypertension: the race against a silent killer. Geneva, Switzerland: World Health Organization; 2023: 1-276
    Search in Google Scholar
  • 2 Yusuf S, Joseph P, Rangarajan S. et al. Modifiable risk factors, cardiovascular disease, and mortality in 155 722 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study. Lancet 2020; 395: 795-808
    Search in Google Scholar
  • 3 Lim SS, Vos T, Flaxman AD. et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380: 2224-2260
    Search in Google Scholar
  • 4 Bundy JD, Li C, Stuchlik P. et al. Systolic blood pressure reduction and risk of cardiovascular disease and mortality: A systematic review and network meta-analysis. JAMA Cardiol 2017; 2: 775-781
    Search in Google Scholar
  • 5 Rahimi K, Bidel Z, Nazarzadeh M. et al. Pharmacological blood pressure lowering for primary and secondary prevention of cardiovascular disease across different levels of blood pressure: an individual participant-level data meta-analysis. Lancet 2021; 397: 1625-1636
    Search in Google Scholar
  • 6 Cohen JS. Adverse drug effects, compliance, and initial doses of antihypertensive drugs recommended by the Joint National Committee vs the Physiciansʼ Desk Reference. Arch Intern Med 2001; 161: 880-885
    Search in Google Scholar
  • 7 Wang Y, Nie J, Ferrari G. et al. Association of physical activity intensity with mortality: A national cohort study of 403 681 US adults. JAMA Intern Med 2021; 181: 203-211
    Search in Google Scholar
  • 8 Lear SA, Hu W, Rangarajan S. et al. The effect of physical activity on mortality and cardiovascular disease in 130 000 people from 17 high-income, middle-income, and low-income countries: the PURE study. Lancet 2017; 390: 2643-2654
    Search in Google Scholar
  • 9 Valenzuela PL, Carrera-Bastos P, Gálvez BG. et al. Lifestyle interventions for the prevention and treatment of hypertension. Nat Rev Cardiol 2021; 18: 251-275
    Search in Google Scholar
  • 10 Pescatello LS, MacDonald HV, Lamberti L. et al. Exercise for hypertension: A prescription update integrating existing recommendations with emerging research. Curr Hypertens Rep 2015; 17: 87
    Search in Google Scholar
  • 11 Naci H, Salcher-Konrad M, Dias S. et al. How does exercise treatment compare with antihypertensive medications? A network meta-analysis of 391 randomised controlled trials assessing exercise and medication effects on systolic blood pressure. Br J Sports Med 2019; 53: 859-869
    Search in Google Scholar
  • 12 Whelton PK, Carey RM, Aronow WS. et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension 2018; 71: 1269-1324
    Search in Google Scholar
  • 13 McEvoy JW, McCarthy CP, Bruno RM. et al. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension. Eur Heart J 2024; 45: 3912-4018
    Search in Google Scholar
  • 14 Kreutz R, Brunström M, Burnier M. et al. 2024 European Society of Hypertension clinical practice guidelines for the management of arterial hypertension. Eur J Intern Med 2024; 126: 1-15
    Search in Google Scholar
  • 15 Mancia G, Kreutz R, Brunström M. et al. 2023 ESH Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Hypertension: Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA). J Hypertens 2023; 41: 1874-2071
    Search in Google Scholar
  • 16 Buchheit M, Laursen PB. High-intensity interval training, solutions to the programming puzzle: Part I: cardiopulmonary emphasis. Sports Med 2013; 43: 313-338
    Search in Google Scholar
  • 17 Jamie JE, Algis HPD, Megan G. et al. Exercise training and resting blood pressure: a large-scale pairwise and network meta-analysis of randomised controlled trials. Br J Sports Med 2023; 57: 1317-1326
    Search in Google Scholar
  • 18 Li L, Liu X, Shen F. et al. Effects of high-intensity interval training versus moderate-intensity continuous training on blood pressure in patients with hypertension: A meta-analysis. Medicine (Baltimore) 2022; 101: e32246
    Search in Google Scholar
  • 19 de Souza Mesquita FO, Gambassi BB, de Oliveira Silva M. et al. Effect of high-intensity interval training on exercise capacity, blood pressure, and autonomic responses in patients with hypertension: A systematic review and meta-analysis. Sports Health 2023; 15: 571-578
    Search in Google Scholar
  • 20 Adams SC, McMillan J, Salline K. et al. Comparing the reporting and conduct quality of exercise and pharmacological randomised controlled trials: a systematic review. BMJ Open 2021; 11: e048218
    Search in Google Scholar
  • 21 Glasziou P, Meats E, Heneghan C. et al. What is missing from descriptions of treatment in trials and reviews?. BMJ 2008; 336: 1472
    Search in Google Scholar
  • 22 Simera I, Moher D, Hirst A. et al. Transparent and accurate reporting increases reliability, utility, and impact of your research: reporting guidelines and the EQUATOR Network. BMC Medicine 2010; 8: 24
    Search in Google Scholar
  • 23 Nieuwlaat R, Schwalm J-D, Khatib R. et al. Why are we failing to implement effective therapies in cardiovascular disease?. Eur Heart J 2013; 34: 1262-1269
    Search in Google Scholar
  • 24 Hacke C, Nunan D, Weisser B. Do exercise trials for hypertension adequately report interventions? A reporting quality study. Int J Sports Med 2018; 39: 902-908
    Search in Google Scholar
  • 25 Hacke C, Schreiber J, Weisser B. Application of the templates TIDieR and CERT reveal incomplete reporting and poor replicability of exercise interventions for type 2 diabetes mellitus. Curr Diabetes Rev 2021; 18: e250821195838
    Search in Google Scholar
  • 26 Bünzen C, Knuth J, Bucher M. et al. CORE-CERT Items as a minimal requirement for replicability of exercise interventions: Results from application to exercise studies for breast cancer patients. J Strength Cond Res 2023; 37: e346-e360
    Search in Google Scholar
  • 27 Harrison JH, Michael AW, Aidan GC. et al. If exercise is medicine, why don’t we know the dose? An overview of systematic reviews assessing reporting quality of exercise interventions in health and disease. Br J Sports Med 2022; 56: 692
    Search in Google Scholar
  • 28 Wells M, Williams B, Treweek S. et al. Intervention description is not enough: evidence from an in-depth multiple case study on the untold role and impact of context in randomised controlled trials of seven complex interventions. Trials 2012; 13: 95
    Search in Google Scholar
  • 29 Page MJ, McKenzie JE, Bossuyt PM. et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021; 372: n71
    Search in Google Scholar
  • 30 Hoffmann TC, Glasziou PP, Boutron I. et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ 2014; 348: g1687
    Search in Google Scholar
  • 31 Slade SC, Dionne CE, Underwood M. et al. Consensus on Exercise Reporting Template (CERT): Explanation and elaboration statement. Br J Sports Med 2016; 50: 1428
    Search in Google Scholar
  • 32 Aghaei Bahmanbeglou N, Ebrahim K, Maleki M. et al. Short-duration high-intensity interval exercise training is more effective than long duration for blood pressure and arterial stiffness but not for inflammatory markers and lipid profiles in patients with stage 1 hypertension. J Cardiopulm Rehabil Prev 2019; 39: 50-55
    Search in Google Scholar
  • 33 Guimarães GV, Ciolac EG, Carvalho VO. et al. Effects of continuous vs. interval exercise training on blood pressure and arterial stiffness in treated hypertension. Hypertens Res 2010; 33: 627-632
    Search in Google Scholar
  • 34 Izadi MR, Ghardashi Afousi A, Asvadi Fard M. et al. High-intensity interval training lowers blood pressure and improves apelin and NOx plasma levels in older treated hypertensive individuals. J Physiol Biochem 2018; 74: 47-55
    Search in Google Scholar
  • 35 Jo EA, Cho KI, Park JJ. et al. Effects of high-intensity interval training versus moderate-intensity continuous training on epicardial fat thickness and endothelial function in hypertensive metabolic syndrome. Metab Syndr Relat Disord 2020; 18: 96-102
    Search in Google Scholar
  • 36 Soltani M, Aghaei Bahmanbeglou N, Ahmadizad SA-O. High-intensity interval training irrespective of its intensity improves markers of blood fluidity in hypertensive patients. Clin Exp Hypertens 2020; 42: 309-314
    Search in Google Scholar
  • 37 MartinezAguirre-Betolaza A, Mujika I, Fryer SM. et al. Effects of different aerobic exercise programs on cardiac autonomic modulation and hemodynamics in hypertension: data from EXERDIET-HTA randomized trial. J Hum Hypertens 2020; 34: 709-718
    Search in Google Scholar
  • 38 Gorostegi-Anduaga I, Corres P, MartinezAguirre-Betolaza A. et al. Effects of different aerobic exercise programmes with nutritional intervention in sedentary adults with overweight/obesity and hypertension: EXERDIET-HTA study. Eur J Prev Cardiol 2018; 25: 343-353
    Search in Google Scholar
  • 39 Molmen-Hansen HE, Stolen T, Tjonna AE. et al. Aerobic interval training reduces blood pressure and improves myocardial function in hypertensive patients. Eur J Prev Cardiol 2012; 19: 151-160
    Search in Google Scholar
  • 40 Mohr M, Nordsborg NB, Lindenskov A. et al. High-intensity intermittent swimming improves cardiovascular health status for women with mild hypertension. Biomed Res Int 2014; 2014: 728289
    Search in Google Scholar
  • 41 Ghardashi Afousi A, Izadi MR, Rakhshan K. et al. Improved brachial artery shear patterns and increased flow-mediated dilatation after low-volume high-intensity interval training in type 2 diabetes. Exp Physiol 2018; 103: 1264-1276
    Search in Google Scholar
  • 42 Dijkers MP. Overview of Reviews Using the Template for Intervention Description and Replication (TIDieR) as a measure of trial intervention reporting quality. Arch Phys Med Rehabil 2021; 102: 1623-1632
    Search in Google Scholar
  • 43 Cornelissen VA, Smart NA. Exercise training for blood pressure: A systematic review and meta-analysis. J Am Heart Assoc 2013; 2: e004473
    Search in Google Scholar
  • 44 Ramos JS, Dalleck LC, Tjonna AE. et al. The impact of high-intensity interval training versus moderate-intensity continuous training on vascular function: a systematic review and meta-analysis. Sports Med 2015; 45: 679-692
    Search in Google Scholar
  • 45 Bird SR, Hawley JA. Update on the effects of physical activity on insulin sensitivity in humans. BMJ Open Sport Exerc Med 2016; 2: e000143
    Search in Google Scholar
  • 46 Costa EC, Hay JL, Kehler DS. et al. Effects of high-intensity interval training versus moderate-intensity continuous training on blood pressure in adults with pre- to established hypertension: A systematic review and meta-analysis of randomized trials. Sports Med 2018; 48: 2127-2142
    Search in Google Scholar
  • 47 Ciolac EG, Bocchi EA, Bortolotto LA. et al. Effects of high-intensity aerobic interval training vs. moderate exercise on hemodynamic, metabolic and neuro-humoral abnormalities of young normotensive women at high familial risk for hypertension. Hypertens Res 2010; 33: 836-843
    Search in Google Scholar
  • 48 MacInnis MJ, Gibala MJ. Physiological adaptations to interval training and the role of exercise intensity. J Physiol 2017; 595: 2915-2930
    Search in Google Scholar
  • 49 Bartlett JD, Close GL, MacLaren DP. et al. High-intensity interval running is perceived to be more enjoyable than moderate-intensity continuous exercise: implications for exercise adherence. J Sports Sci 2011; 29: 547-553
    Search in Google Scholar
  • 50 Ekkekakis P, Biddle SJH. Extraordinary claims in the literature on high-intensity interval training (HIIT): IV. Is HIIT associated with higher long-term exercise adherence?. Psychol Sport Exerc 2023; 64: 102295
    Search in Google Scholar
  • 51 Abell B, Glasziou P, Hoffmann T. Reporting and replicating trials of exercise-based cardiac rehabilitation: do we know what the researchers actually did?. Circ Cardiovasc Qual Outcomes 2015; 8: 187-194
    Search in Google Scholar
  • 52 Kunath F, Grobe HR, Rücker G. et al. Do journals publishing in the field of urology endorse reporting guidelines? A survey of author instructions. Urol Int 2012; 88: 54-59
    Search in Google Scholar
  • 53 Samaan Z, Mbuagbaw L, Kosa D. et al. A systematic scoping review of adherence to reporting guidelines in health care literature. J Multidiscip Healthc 2013; 6: 169-188
    Search in Google Scholar
  • 54 Mills E, Wu P, Gagnier J. et al. An analysis of general medical and specialist journals that endorse CONSORT found that reporting was not enforced consistently. J Clin Epidemiol 2005; 58: 662-667
    Search in Google Scholar
  • 55 Schulz KF, Altman DG, Moher D. et al. CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. BMC Medicine 2010; 8: 18
    Search in Google Scholar