Two people exercising in a gym.

For Female Patients, This Rehab Option is a Real HIIT

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The heart is a muscle, and just like the other muscles in your body, it can grow with regular exercise and potentially undergo rehabilitation with proper physical therapy. This is important to note when we consider that cardiovascular disease is the leading cause of death in adults today — and for women, additional comorbidities such as hormonal fluctuations can make these cardiac issues worse.

Cardiac rehabilitation is an established method for treating cardiovascular disease, but it’s often underutilized by women due to a lack of referrals, time, and female-oriented programming. This has the potential to cause a lot of harm to female heart disease patients, and highlights the need for alternative and more inclusive programming.

A recent study from the University of Ottawa‘s Heart Institute investigated rehabilitation methods that may address this gap. The study was led by Sol Vidal-Almela, a PhD candidate supervised by University of Ottawa associate professor Jennifer Reed, and published in Applied Physiology, Nutrition, and Metabolism. Reed is also the Director of the Exercise Physiology and Cardiovascular Health Laboratory at the Heart Institute, where her research focuses on the role of exercise in treating and preventing heart disease, as well as developing new forms of female-oriented cardiac training.

The present study investigated high-intensity interval training, or HIIT, which involves short periods of high-intensity exercises interspersed with frequent recovery periods. Even just as a form of exercise (not related to heart disease), HIIT has been shown to be effective and often more accessible than other forms of cardiovascular exercise. The goal of this study was to better understand the impact as HIIT as a form of cardiac rehabilitation in heart disease patients, specifically looking at sex differences in both physical and mental health outcomes.

To learn more, the researchers recruited both male and female patients who were diagnosed with cardiovascular disease, and held group-based exercise sessions twice a week for 10 weeks. They monitored the patients’ physical and mental health throughout this period.

The team found that all patients who participated in HIIT exercise improved their maximum oxygen consumption, but that there was no difference between sexes in terms of physical health outcomes. This was also true for other outcomes of physical health such as body mass index, blood sugar levels, and blood pressure. However, a follow-up analysis of patients six months after the study revealed that female patients had improved their maximum oxygen consumption scores significantly more than males.

What about mental health? The study showed a major impact of HIIT exercise on mental health outcomes such as depression and anxiety levels, and the researchers found that these gains persisted over time. However, similar to physical health outcomes, there was no sex difference in mental health outcomes.

Yet while the physical and mental health outcomes of the trials were similar for men and women, the researchers also found that HIIT resulted in high adherence and compliance in female patients — something that isn’t necessarily observed for other rehabilitation methods.

This suggests that female patients who suffer from cardiovascular disease may respond better to HIIT than other rehabilitation methods.

This study highlights the importance of considering sex when assessing medical treatment options. Overall, incorporating HIIT training in the treatment of cardiovascular disease may help narrow the sex gap in health outcomes that is currently seen following other forms of treatment.

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Salma is a PhD student in the Department of Immunology at the University of Toronto, where she also completed her MSc and HBSc. She is passionate about equity, accessibility and transparency in science, and is excited about helping highlight Canadian research!