Practical Recommendations for

High-Intensity Interval Training for

Adults with Cardiovascular Disease
by Kimberley L. Way, Ph.D., AEP; Tasuku Terada, Ph.D., ACSM-CEP; Carley D. O’Neill, Ph.D.;
Sol Vidal-Almela, M.Sc.; Andrew Keech, Ph.D.; and Jennifer L. Reed, Ph.D., RKin
AN OVERVIEW OF HIGH-INTENSITY INTERVAL TRAINING FOR ADULTS WITH
Apply It! CARDIOVASCULAR DISEASE

C
ardiovascular disease (CVD) remains the leading cause of death in the
 High-intensity interval training United States (1). Low levels of exercise are a major risk factor for CVD,
(HIIT) can be implemented and there is irrefutable evidence that regular exercise is effective in
safely in adults with cardiovas- managing CVD, lowering the risk of first or subsequent cardiovascular
cular disease (CVD) after a events (1). Because many adults with CVD consider lack of time a
graded exercise test assessing barrier to exercise, high-intensity interval training (HIIT) may be an appealing exercise
exercise responses at a high in- training paradigm as cardiovascular health benefits can be achieved in less time than
tensity (e.g., to 85% heart rate traditional moderate-to-vigorous intensity continuous training (MICT). HIIT may also
peak [HRpeak] or a rating of per- address other frequently reported deterrents to MICT, including lack of interest and
ceived exertion [RPE] of 15). motivation, boredom, not challenging enough, and tailored for older people’s needs.
 Always involve the patient in For the purposes of this article, sprint interval training (SIT) will not be discussed as a
the decision-making process form of interval training. To date, there is no evidence evaluating the safety and efficacy
for selecting the mode of exer- of SIT for cardiovascular health outcomes in people with CVD. Therefore, this mode of
cise to perform HIIT to increase interval training is not currently recommended for this population group.
adherence, compliance, and Systematic reviews, meta-analyses, and additional original work in adults with cardiomet-
enjoyment to the exercise abolic and CVD have demonstrated comparable or greater improvements after HIIT
program. when compared with MICT in cardiorespiratory fitness (V̇O2peak) (2), diastolic blood
 Given the low exercise toler- pressure (3), high-density lipoprotein (4), vascular function (5), and body composition (i.e.,
ance that is typically experi- total body fat, abdominal fat mass, and body mass index) (6). Few studies have addressed
enced by patients with CVD,
short duration high-intensity
bouts (e.g., 30 seconds to
1 minute) may be necessary
to increase exercise tolerance
and self-efficacy. Active or pas-
sive recovery interspersed be-
tween high-intensity intervals
should be equal to or greater
than the duration of the high-
intensity intervals. Passive re-
coveries should be avoided if
a person experiences vasova-
gal symptoms/events.
Key words: Cardiovascular Disease,
Cardiorespiratory Fitness, FITT
principles, High Intensity Interval
Training, Moderate-intensity
Continuous Training

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Copyright © 2021 American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
HIIT FOR ADULTS WITH CARDIOVASCULAR DISEASE
quality of life and mental health (i.e., anxiety, depression) (7).
Readers are referred to Heinz et al. in this issue for more on
HIIT and mental health.
SCREENING
When prescribing any exercise program, it is important to con-
sider and obtain information on the patient’s reason for referral,
exercise history and preferences (such as modes of exercise), and
comorbidities (e.g., osteoarthritis of joints, obesity, etc.). Individuals
with established CVD who participate in HIIT should seek medical
clearance; the type of medical evaluation is left to the discretion and
clinical judgment of the provider (8). If a maximal symptom-limited
cardiopulmonary exercise test (CPET) is conducted, exercise
intensity can be prescribed using measured peak/maximum heart
rate (HRpeak/max), peak/maximum exercise capacity (V̇O2peak/max),
or peak/maximum workload. Such individualized exercise
prescriptions maximize health benefits through increases in
cardiorespiratory fitness, quality of life, mental health, and
lowered CVD risk factors, while ensuring the exercise intensity
is safely below the threshold for triggering cardiovascular symptoms
or events.
When prescribing any exercise program, it is
important to consider and obtain information on
the patient’s reason for referral, exercise history
and preferences (such as modes of exercise),
and comorbidities (e.g., osteoarthritis of joints,
obesity, etc.). Individuals with established CVD
who participate in HIIT should seek medical
clearance; the type of medical evaluation is left to
the discretion and clinical judgment of the
provider (8).
EXERCISE PRESCRIPTION FOR HIIT IN CVD
Patients should be included in the decision-making process
when devising the HIIT prescription to increase adherence,
compliance, and enjoyment (9). Individuals with CVD should
be advised to monitor for signs and symptoms during an
exercise session that may arise such as dizziness, severe
shortness of breath, nausea, and angina. Further, it is important
to provide patients with the skills and knowledge to perform
HIIT in a home-based environment. HIIT sessions should be
supervised for the first 1 to 2 wk to (i) monitor physiological
responses to HIIT, (ii) familiarize the individual to HIIT, (iii)
evaluate compliance, (iv) address any progression or regression to
exercise prescription, (v) educate the patient on methods to
monitor exercise intensity, and (vi) gradually reduce supervision
36 ACSM’s Health & Fitness Journal ®
Copyright © 2021 American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
to increase patient autonomy and self-efficacy (see self-efficacy
and barriers to exercise training section below).
WARM-UP AND COOL-DOWN
An aerobic warm-up and cool-down should precede and follow
HIIT, respectively. A 5- to 10-minute warm-up that gradually
increases from a light to moderate intensity is recommended.
However, in patients with angina or with chronotropic incompetence,
a longer duration warm-up may be beneficial. A 5- to 10-minute
gradual reduction to light-intensity cool-down after HIIT is im-
portant to prevent vasovagal events and allow physiological re-
sponses to return to near-resting levels.
FITT PRINCIPLES
As per ACSM’s Guidelines for Exercise Testing and Prescription, exercise
prescription is composed of four main principles (8): (i) frequency
(number of sessions per week), (ii) intensity (exertion during
exercise), (iii) time (duration of session), and (iv) type (mode of
exercise) (FITT). The volume (total amount of exercise) and
progression or regression of exercise prescription needs to be
considered to ensure that exercise prescription is individually
tailored. Tables 1 and 2 provide case study examples on how
the FITT principles may be implemented in adults with CVD.
FREQUENCY
Although it is recommended that patients with CVD engage in
aerobic exercise 3 to 5 days per week (8), most studies have
implemented HIIT 2 to 3 days per week (2,10), which appears
to lead to high adherence (11). For patients with low exercise
tolerance, the frequency of HIIT should be 2 to 3 days per
week until self-efficacy with exercise increases. Before intro-
ducing an additional session per week, monitor tolerance (e.g.,
reduction or elevation in Borg ratings of perceived exertion
[RPE], ability to comply to exercise intensity and duration)
and adherence to the frequency of HIIT sessions prescribed.
For patients with a moderate to high exercise tolerance, fre-
quency may start at ≥3 days per week. Exercise volume may
be increased by including an additional HIIT session per week
if HIIT is well tolerated and feasible (e.g., schedule availability)
for the patient.
INTENSITY
The high-intensity bouts should be prescribed at 80% to 100%
HRpeak/max or V̇O2peak/max (8) or an RPE of 15 to 18/20 (12),
interspersed with active or passive recovery (i.e., rest). Previous
work has shown that the inclusion of short passive recovery
(~30 seconds) increases exercise tolerance in heart failure patients
(13). However, passive recovery may increase the risk of vasovagal
events because of blood pooling into the extremities. Careful
monitoring by the exercise professional for signs and symptoms
of a vasovagal event is imperative. Furthermore, in patients
with ischemic heart disease, exertional angina is attenuated or
dissipated if intensity is briefly reduced before resuming exercise
at the same or higher levels of exercise intensity (8). As most
September/October 2021
patients with CVD are prescribed b-blockers with HR blunting
effects, RPE is the preferred method of monitoring intensity.
For patients who have a low exercise tolerance or lack
self-efficacy with high-intensity exercise, higher-intensity bouts
should be gradually increased from moderate intensity (e.g.,
64% to 76% HRpeak/max or RPE, 12 to 13/20) (8) to high
intensity. Intensity should be progressed as tolerated by the
patient until the high-intensity range is achieved. Active
recoveries should be reduced to low-intensity (RPE, 9 to 10;
50% to 55% HRpeak/max) to allow patients to recover and be
familiarized with HIIT protocols.
When progressing from a supervised to home-based HIIT
program (see Figure), patients should be encouraged to use the
Talk Test—a practical and feasible tool for monitoring exercise
intensity for HIIT in supervised and home settings. While using
the Talk Test, when the patient is aiming for the high-intensity
range, intensity, or workload should be increased if holding a
conversation feels comfortable. Patients should be able to hold a
comfortable conversation during light to moderate exercise (i.e.,
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active recoveries) but not during high-intensity bouts. The Talk
Test may not be appropriate for shorter duration high-intensity
intervals (e.g., 30 seconds to 1 minute) because of the lack of sen-
sitivity to detect rapid changes in exercise intensity (14). The
Talk Test should therefore be implemented with longer duration
intervals (>1 minute).
Wearables (e.g., smartwatches, smart patches, smart phones,
etc.) may be helpful for monitoring intensity when transitioning
from a supervised to home-based HIIT program. Output from
these devices should be reviewed during a supervised session
with a patient to educate them on which physiological responses
to HIIT should be monitored using such devices and how to
modify HIIT accordingly.
TIME
Several HIIT protocols have been studied with different dura-
tions for the work and recovery bouts, including the 4  4 proto-
col (i.e., 4 bouts of 4-minute high-intensity exercise interspersed
with 3-minute recovery periods) and the 10  1 minute protocol
www.acsm-healthfitness.org 37
HIIT FOR ADULTS WITH CARDIOVASCULAR DISEASE
(i.e. 10 bouts of 1-minute high-intensity exercise interspersed with
1-minute recovery periods). Previous studies have predominately
prescribed HIIT sessions up to 30 minutes in duration, consisting
of 4 to 10 high-intensity bouts for 1 to 4 minutes with active recov-
eries for 1 to 3 minutes. Meyer et al. (13) found that shorter
duration high-intensity bouts (i.e., 30 seconds to 1 minute) with
equal duration of passive recovery were the most well-received
HIIT protocol for heart failure patients when compared with
longer duration intervals (i.e., 90 seconds). Interestingly, patients
were unable to maintain exercising at high intensity when asked to
cycle for longer than 90 seconds (13). Despite evidence suggesting
that the 4  4 protocol is well tolerated by patients with CVD,
commencing HIIT with shorter duration high-intensity bouts may
be necessary given their low exercise tolerance and to increase self-
efficacy. Further, to assist with the initial integration of HIIT
into an exercise program, shorter HIIT sessions, with a total
duration of ≤10 minutes, also could be implemented. Duration may
be progressed by increasing the number of intervals completed
or the length of time spent at high intensity. Alternatively, HIIT
may be regressed by reducing the time spent at high intensity
and increasing the duration of recovery between bouts.
TYPE
To increase exercise enjoyment and adherence to HIIT, patient
preference should be considered upon exercise selection. Where
possible, exercise involving large muscle groups, such as walking,
jogging, swimming, cycling, rowing, dancing, boxing, or aero-
bics, should be encouraged.
SPECIAL CONSIDERATION FOR PATIENTS ON b-BLOCKERS
Most patients with CVD are prescribed medications that can affect
their cardiac output, blood pressure, cardiac electrophysiology,
and cardiorespiratory fitness. The effects of b-blockers on exercise
responses are important to consider. HR response is blunted in
38 ACSM’s Health & Fitness Journal ®
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patients treated with b-blockers, which limits exercise performance
(i.e., decreases V̇O2 peak) (15). When conducting CPET for the
purposes of exercise prescription, the timing of b-blockers with
respect to exercise testing and training participation should be
considered and standardized to prescribe efficacious and safe
HIIT protocols. Alternatively, exercise intensity for HIIT may be
prescribed using estimated HRpeak/max adjusted for b-blockers
(HRpeak/max, 30 bpm) or RPE (14). Caution is warranted,
however, when prescribing exercise intensity based on estimated
HR, as its accuracy is influenced by the method used. Direct
measurement of the physiological responses to exercise through
incremental CPET is preferred whenever possible.
Most patients with CVD are prescribed
medications that can affect their cardiac output,
blood pressure, cardiac electrophysiology, and
cardiorespiratory fitness. The effects of
b-blockers on exercise responses are important
to consider. HR response is blunted in patients
treated with b-blockers, which limits exercise
performance (i.e., decreases V̇ O2 peak) (15).
There are no clear guidelines or data to suggest that patients
without a baseline CPET should not participate in HIIT. How-
ever, when CPET screening is not available, as in many clinical
settings, patients who seek to participate in HIIT should be clin-
ically stable and complete a submaximal exercise test (16) to
evaluate physiological responses to high-intensity exercise to en-
sure HIIT is a safe option (17). Thereafter, patients may
September/October 2021
TABLE 1: Case Study 1
Monday Wednesday Saturday
Weeks 1–2
F: 1/3 session (in-clinic supervised) F: 2/3 session (in-clinic supervised) F: 3/3 session (unsupervised home based)
I*: high intensity, 15 + active recovery, 9–10 I*: high intensity, 15 + active recovery, I*: moderate intensity 14 + active recovery,
9–10 9–10
T: 4  1 minute at high intensity with T: 8  30 seconds at high intensity with T: 4  1 minute at moderate intensity with
2 minutes active recovery between 1 minute active recovery between each 2 minutes active or passive (e.g., rest on
each work interval work interval a bench) recovery between each work interval
T: upright or recumbent cycle ergometer T: elliptical T: walking in her neighborhood with a friend
or family member
Weeks 3–4
F: 1/3 session (unsupervised home based) F: 2/3 session (in-clinic supervised) F: 3/3 session (unsupervised home based)
I*: high intensity, 15 + active recovery, 9–10 I*: high intensity, 15–16 + active I*: moderate intensity, 14 + active recovery,
recovery, 9–10 9–10
T: 4  2 minutes at high intensity with T: 10  30 seconds at high intensity T: 4  2 minutes at moderate intensity
2 minutes active recoveries in between with 1 minute active recovery between with 2 minutes active recoveries in between
each work interval
T: half the session as aerobics; the T: elliptical T: brisk walking in her neighborhood
other half as air boxing
Weeks 5–6
F: 1/3 session (unsupervised home based) F: 2/3 session (supervised) F: 3/3 session (unsupervised home based)
I*: high intensity, 15–16 + active recovery, I*: high intensity, 15–16 + active I: high intensity, 15–16 + active
11–12 recovery, 11–12 recovery, 11–12
T: 4  2 minutes at high intensity with T: 10  30 seconds at high intensity T: 4  2 minutes at high intensity with
2 minutes active recoveries in between; with 1 minute active recovery between 2 minutes active recoveries in between
can add a repeated block after 3 minutes each work interval; can add a repeated
of passive rest block after 3 minutes of passive rest
T: half the session as aerobics; the T: elliptical T: brisk walking in her neighborhood or
other half as air boxing air boxing
Patient: 68-year-old female with heart failure; low exercise tolerance (<5 METs); sedentary; body mass index = 27 kg·m−2; left knee osteoarthritis; type 2 diabetes; low
self-efficacy when performing exercise.
If the patient tolerates the sessions well toward the end of week 2, progress by increasing the duration of the moderate-intensity interval, reducing the active recovery
time, or increasing the intensity to high. Note that the prescription can be regressed if the patient finds it too difficult. Given a patient’s low self-efficacy, small short-term
goals should be set, and reinforcements with positive feedback should be provided when they are achieved.
If tolerated well by the patient toward the end of week 4, increase the intensity to reach high intensity and progressively reduce the active recovery time. To continue to
increase patient’s self-efficacy, the regular use of behavioral change techniques is encouraged.
*Intensity based on 6–20 Borg RPE scale.

incorporate a small number of short high-intensity bouts (e.g.,
initially 2 to 4 bouts, 30 seconds to 1-minute per bout) separated
by sufficient recovery periods (≥1:1 work–rest ratio) under the
supervision of certified exercise professionals.
CONTRAINDICATIONS
There are no specific contraindications for prescribing HIIT in
adults with CVD. Considering the greater stress high-intensity
exercise imposes on the cardiovascular system, applying the
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exercise contraindications for patients with CVD may be the
most conservative approach (8).
PACEMAKER AND IMPLANTABLE CARDIOVERTER
DEFIBRILLATORS
Exercise professionals should follow the exercise considerations
for those with pacemakers or implantable cardioverter defibril-
lators (ICDs) as provided in ACSM’s Guidelines for Exercise
Testing and Prescription when prescribing HIIT. There is no
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HIIT FOR ADULTS WITH CARDIOVASCULAR DISEASE
TABLE 2: Case Study 2
Monday Wednesday Thursday Saturday
Weeks 1–2
F: 1/4 session (in-clinic F: 2/4 session (unsupervised F: 3/4 session (unsupervised F: 4/4 session (in-clinic
supervised) home based) home based) supervised)
I*: high intensity, 15–16 + I*: high intensity, 15–16 + I*: high intensity, 15–16 + I*: High intensity, 15–16 +
active recovery, 9–10 active recovery, 9–10 active recovery, 9–10 active recovery, 9–10
T: 4  2 minutes at high T: 4  2 minutes at high T: 4  2 minutes at high T: 2 blocks of 8  30 seconds at
intensity with 2 minutes active intensity with 2 minutes active intensity with 2 minutes active high intensity with 30 seconds
recoveries in between recoveries in between recoveries in between active recovery between
intervals and 1 minute of passive
recovery between blocks
T: upright cycle ergometer T: jogging outdoors T: jogging outdoors T: boxing and elliptical
Weeks 3–4
F: 1/4 session (in-clinic F: 2/4 session (unsupervised F: 3/4 (unsupervised home F: 4/4 session (in-clinic
supervised home based based) supervised)
I*: high intensity, 15–16 + I*: high intensity, 15–16 + I*: high intensity, 15–16 + I*: high intensity, 15–16 +
active recovery, 9–10 active recovery, 9–10 active recovery, 9–10 active recovery, 9–10
T: 4  3 minutes at high T: 2 blocks of 8  30 seconds at T: 4  3 minutes at high T: 2 blocks of 8  1 minute at
intensity with 2 minutes active high intensity with 30 seconds intensity with 2 minutes active high intensity with 1 minute
recoveries in between active recovery between recoveries in between active recovery between
intervals and 1 minute of passive intervals and 1 minute of passive
recovery between blocks recovery between blocks
T: upright cycle ergometer T: outdoor jogging or walking T: outdoor jogging or walking T: boxing and elliptical
on hilly terrain on hilly terrain
Patient: 65-year-old male with moderate to high exercise tolerance (>5 METs); physically active lifestyle; body mass index = 24 kg·m−2; high self-efficacy when per-
forming exercise.
*Intensity based on 6–20 Borg RPE scale.

evidence of increased risk of shocks in patients with a pace-
maker or ICD who engage in exercise training (18).
Exercise professionals should obtain the HR threshold for an
ICD and prescribe exercise 10 bpm below the HR threshold.
A systematic review showed that supervised exercise training
at moderate to high intensity (including a study prescribing
HIIT) is a safe and effective intervention for patients with a
pacemaker or ICD in improving cardiopulmonary outcomes
without adverse events (19). Given the limited evidence, the same
precautions as other cardiovascular conditions (i.e., medical
clearance from a physician, exercise testing to evaluate HR and
rhythm responses, and beginning with lower-intensity exercise)
should be practiced.
SURGICAL INTERVENTIONS
Many patients with CVD undergo percutaneous transluminal
coronary intervention (PCI) or coronary artery bypass graft
(CABG) surgery for the treatment of atherosclerosis. Exercise
professionals should monitor any discomfort or pain at the inci-
sion sites (i.e., the radial or femoral artery) after a PCI or a
40 ACSM’s Health & Fitness Journal ®
CABG when performing HIIT. Any exercises that cause pain
at the incision site should be avoided. A patient who reports
the same or worsening symptoms experienced before PCI or
CABG (e.g., angina, unusual shortness of breath, and fatigue)
during HIIT should be referred to their specialist for further
evaluation before commencing or continuing with an exercise
program. ACSM’s special considerations for sternotomy should
be followed for any patient recovering from a CABG (8).
ARRHYTHMIAS
Abnormalities of cardiac rhythm are associated with substantial
economic costs, morbidity, and mortality (20). Atrial fibrillation
(AF), bradyarrhythmias, and conduction system diseases are the
most frequently observed rhythm abnormalities in the community
(19). Their risk factors include older age, male sex, white race,
and multiple cardiovascular comorbidities (20). The response to
exercise training is presumably different in those with arrhythmias
because of their unique rate and/or rhythm control issues that
are not seen in other cardiovascular disorders. Consequently, HR
is not advisable to prescribe HIIT in adults with arrhythmias.
September/October 2021

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Figure. Recommended exercise intensity and symptom monitoring tools to transition from supervised to unsupervised high-
intensity interval training.
Other methods such as % of V̇O2peak or V̇O2 reserve (although not
practical for many clinical settings to obtain given the time, costs,
equipment, and trained personnel required to measure),
workload, RPE, or the Talk Test are advised. HIIT has been
shown to be beneficial in patients with nonpermanent AF. Malmo
et al. (21) demonstrated reductions in time in AF (−3.3%) after
a 12 week HIIT (4  4-minute intervals at 85% to 95% of
HRpeak) program with sessions three times per week.
SEX DIFFERENCES
Females with CVD tend to be older in age, have more comor-
bidities, and have poorer lifestyle behaviors (e.g., females tend
to be less physically active) than males; this will impact the selec-
tion of the most appropriate HIIT prescription and progression.
Whether HIIT elicits similar adaptations in females and
males with CVD remains unclear. Postmenopausal females,
who represent the majority of females with CVD, have been
shown to improve V̇O2peak to a lesser extent than males following
the same exercise stimulus (22); thus, females with CVD may
benefit from the higher exercise stimulus elicited by HIIT. A
systematic review (10) did not find sex differences in the relative
(%) improvement in V̇O2peak in cardiac patients after HIIT.
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HIIT may be a more appropriate alternative to traditional MICT
to avoid further broadening of sex differences in V̇O2peak in
females and males with CVD.
SAFETY OF HIIT IN INDIVIDUALS WITH CVD
The risks associated with HIIT will likely be influenced by the
intensity and duration of the high-intensity work bouts, as well
as the duration of recovery periods. A meta-analysis in adults
with coronary artery disease or heart failure has shown that
the risk of a major or minor cardiovascular event was very low
when HIIT sessions were supervised and preceded by CPET
with electrocardiography (1 per 17,083 HIIT sessions and 1 per
8,541 HIIT sessions, respectively) (23). Exercise professionals
should be reassured that CVD events are rare during HIIT,
and HIIT appears safe in people with CVD.
SELF-EFFICACY AND BARRIERS TO EXERCISE TRAINING
Barriers to participation in regular exercise training in the gen-
eral community are wide ranging, with the most common being
lack of time, inaccessibility to equipment and associated costs,
and lack of skills, education, motivation, and low self-efficacy. Ex-
ercise professional supervision of home-based HIIT via telehealth
www.acsm-healthfitness.org 41
HIIT FOR ADULTS WITH CARDIOVASCULAR DISEASE
A meta-analysis in adults with coronary artery
disease or heart failure has shown that the risk
of a major or minor cardiovascular event was
very low when HIIT sessions were supervised
and preceded by CPET with electrocardiography
(1 per 17,083 HIIT sessions and 1 per 8,541 HIIT
sessions, respectively) (23). Exercise
professionals should be reassured that CVD
events are rare during HIIT, and HIIT appears
safe in people with CVD.
has promise for lowering the barriers of accessibility and time
constraints in a cost-effective way (24); however, it has a
downside for application with HIIT because of the decreased
ability to monitor patients. The remote application of HIIT
via telehealth may be most appropriate after stable physiolo-
gical responses to HIIT have been established in face-to-face
sessions, as well as after successful patient education on how to
appropriately conduct unsupervised HIIT at home or in the
community. Wearable technology, especially the monitoring of
HR and the incidences of AF via smart watches, can have use with
telehealth to remote monitor HIIT sessions in these patients.
SUMMARY
HIIT appears to be a safe, feasible, and effective aerobic exer-
cise modality that can be included into the exercise prescription
for people with CVD. This may be particularly useful for younger
individuals and females with CVD who may need more aggressive
exercise approaches to elicit increases in cardiorespiratory fitness
and other cardiovascular health benefits. Exercise professionals
should aim to educate and provide their patients with the appropri-
ate tools to complete HIIT unsupervised to enable and empower
people with CVD to integrate HIIT into their lifestyle.
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September/October 2021
 Kimberley L. Way, Ph.D., AEP, is a lec-
turer in the School of Exercise and Nutrition
Sciences and a clinician researcher at the In-
stitute for Physical Activity and Nutrition
(IPAN) at Deakin University, Australia.
She is an accredited exercise physiologist
with ~10 years of experience, predomi-
nately in cardiovascular rehabilitation.
Dr. Way’s research program examines the role of exercise and
physical activity in the management and prevention of cardiovas-
cular pathologies with a specific focus in adults with cardiomet-
abolic diseases.
Tasuku Terada, Ph.D., ACSM-CEP, is an
ACSM-certified clinical exercise physiolo-
gist and a senior postdoctoral research fellow
in the Exercise Physiology and Cardiovascu-
lar Health Lab housed in the division of
Cardiac Prevention and Rehabilitation
at the University of Ottawa Heart Insti-
tute, Canada. His research focuses on
exploring the role of exercise in counteracting the development
or progression of chronic health conditions, including obe-
sity, type 2 diabetes, and cardiovascular disease.
Carley D. O’Neill, Ph.D., is a strategic
endowed postdoctoral research fellow in
the Exercise Physiology and Cardiovas-
cular Health Lab at the University of
Ottawa Heart Institute and a certified
exercise physiologist with the Canadian
Society for Exercise Physiology. Her
areas of research include exercise physiol-
ogy, cardiovascular and respiratory health,
and women’s health.
Sol Vidal-Almela, M.Sc., originally
from Spain, completed an M.Sc. in Clin-
ical Exercise Physiology at Liverpool
John Moores University, England, and
is now a Ph.D. candidate in Human Ki-
netics in the Exercise Physiology and Car-
diovascular Health Lab at the University
Volume 25 | Number 5
Copyright © 2021 American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
of Ottawa Heart Institute, Canada. She has a strong interest in
advancing our understanding of sex- and gender-based differ-
ences in the response to acute and chronic exercise in clinical pop-
ulations such as patients with heart disease.
Andrew Keech, Ph.D., has been an exer-
cise science practitioner for more 20 years
and a lecturer in Exercise Physiology at the
University of New South Wales, Australia,
for 8 years. Andrew is currently focused on
researching the benefits of exercise for cardio-
vascular health and fitness in healthy and
chronic illness populations, with an empha-
sis on high-intensity interval training.
Jennifer L. Reed, Ph.D., RKin, is the di-
rector of the Exercise Physiology and Car-
diovascular Health Lab at the University
of Ottawa Heart Institute, assistant profes-
sor in the School of Epidemiology and Public
Health, and adjunct professor in the School
of Human Kinetics at the University of
Ottawa, Canada. Her research program
examines the role of exercise in cardiovascular disease preven-
tion and rehabilitation, with a particular focus on women’s
heart health and atrial fibrillation.
BRIDGING THE GAP
This article equips exercise professionals with practical
instructions on how to implement a safe and
evidence-based approach to HIIT in adults with CVD while
considering the lack of specialized equipment in most
commercial gyms or cardiovascular rehabilitation
facilities. Exercise professionals are further provided with
a guide on how to safely transition a patient from a
supervised to a home-based HIIT program to integrate
such exercise into their physical activity routines.
www.acsm-healthfitness.org 43