High-intensity Interval Training for Older Adults: Safety Issues


  •   Shigenori Ito


High-intensity interval training (HIIT) has been reported to become an alternative of moderate-intensity continuous training and adapted even in older adults. However, to implement the use of HIIT for older adults, who are very often associated with life-style related and chronic diseases, safety issues should be considered in the first place. However, at present, the evaluation of the safety of HIIT among older adults is compromised by the limited availability of relevant data due to the low proportion of studies reporting adverse events. In this review, update data regarding safety and check-up methods for older adults are described in submaximal HIIT and spring interval training.

Keywords: Aerobic, check-up, high-intensity interval training, older, sprint interval training, safety


Wang Y, Nie J, Ferrari G, Rey-Lopez JP, Rezende LFM. Association of Physical Activity Intensity With Mortality: A National Cohort Study of 403 681 US Adults. JAMA Intern Med. 2020.

Metter EJ, Talbot LA, Schrager M, Conwit R. Skeletal muscle strength as a predictor of all-cause mortality in healthy men. J Gerontol A Biol Sci Med Sci. 2002; 57: B359-65.

Riebe D, Franklin BA, Thompson PD, Garber CE, Whitfield GP, Magal M, et al. Updating ACSM's Recommendations for Exercise Preparticipation Health Screening. Med Sci Sports Exerc. 2015; 47: 2473-9.

Ito S. Rationale and optimising of outcomes in high-intensity interval training for health and disease. J Phys Fitness Sports Med. 2021; 10: 151-64.

Núñez Vergara C, Smith Plaza R, Pérez Ramírez N. [Effectiveness of high intensity interval training in the cardiorespiratory capacity of people older than 65 years old: A systematic review]. Rev Esp Geriatr Gerontol. 2021.

Adamson SB, Lorimer R, Cobley JN, Babraj JA. Extremely short-duration high-intensity training substantially improves the physical function and self-reported health status of elderly adults. J Am Geriatr Soc. 2014; 62: 1380-1.

Losa-Reyna J, Baltasar-Fernandez I, Alcazar J, Navarro-Cruz R, Garcia-Garcia FJ, Alegre LM, et al. Effect of a short multicomponent exercise intervention focused on muscle power in frail and pre frail elderly: A pilot trial. Exp Gerontol. 2019; 115: 114-21.

Maire J, Faillenet-Maire AF, Grange C, Dugué B, Tordi N, Parratte B, et al. A specific arm-interval exercise program could improve the health status and walking ability of elderly patients after total hip arthroplasty: a pilot study. J Rehabil Med. 2004; 36: 92-4.

Tanabe K, Osada N, Noda K, Yamamoto M, Omiya K, Itoh H, et al. Changes in hemodynamics and catecholamines during single-level exercise at the anaerobic threshold and 120% of the anaerobic threshold in normal subjects. J Cardiol. 1994; 24: 61-9.

Adamson S, Kavaliauskas M, Yamagishi T, Phillips S, Lorimer R, Babraj J. Extremely short duration sprint interval training improves vascular health in older adults. Sport Sci Health. 2018.

Hedlund M, Lindelof N, Johansson B, Boraxbekk CJ, Rosendahl E. Development and Feasibility of a Regulated, Supramaximal High-Intensity Training Program Adapted for Older Individuals. Front Physiol. 2019; 10: 590.

Campbell WW, Kraus WE, Powell KE, Haskell WL, Janz KF, Jakicic JM, et al. High-Intensity Interval Training for Cardiometabolic Disease Prevention. Med Sci Sports Exerc. 2019; 51: 1220-6.

Rognmo O, Moholdt T, Bakken H, Hole T, Molstad P, Myhr NE, et al. Cardiovascular risk of high- versus moderate-intensity aerobic exercise in coronary heart disease patients. Circulation. 2012; 126: 1436-40.

Thompson PD, Baggish AL, Franklin B, Jaworski C, Riebe D. American college of sports medicine expert consensus statement to update recommendations for screening, staffing, and emergency policies to prevent cardiovascular events at health fitness affilities. Current Sports Medicine Reports. 2020; 19: 223-31.

Wewege MA, Ahn D, Yu J, Liou K, Keech A. High-Intensity Interval Training for Patients With Cardiovascular Disease-Is It Safe? A Systematic Review. J Am Heart Assoc. 2018; 7: e009305.

Hannan AL, Hing W, Simas V, Climstein M, Coombes JS, Jayasinghe R, et al. High-intensity interval training versus moderate-intensity continuous training within cardiac rehabilitation: a systematic review and meta-analysis. Open Access J Sports Med. 2018; 9: 1-17.

Quindry JC, Franklin BA, Chapman M, Humphrey R, Mathis S. Benefits and Risks of High-Intensity Interval Training in Patients With Coronary Artery Disease. Am J Cardiol. 2019; 123: 1370-7.

Franklin BA. Cardiovascular events associated with exercise. The risk-protection paradox. J Cardiopulm Rehabil. 2005; 25: 189-95.

Thompson PD. The cardiovascular complications of vigorous physical activity. Arch Intern Med. 1996; 156: 2297-302.

Ito S. High-intensity interval training for health benefits and care of cardiac diseases - The key to an efficient exercise protocol. World J Cardiol. 2019; 11: 171-88.

Taylor JL, Holland DJ, Spathis JG, Beetham KS, Wisløff U, Keating SE, et al. Guidelines for the delivery and monitoring of high intensity interval training in clinical populations. Prog Cardiovasc Dis. 2019; 62: 140-6.

Fletcher GF, Ades PA, Kligfield P, Arena R, Balady GJ, Bittner VA, et al. Exercise standards for testing and training: a scientific statement from the American Heart Association. Circulation. 2013; 128: 873-934.

Medcine ACoS. ACSM guideline for exercie testing and prescription 9th ed. Philadelphia, PA: Lippincott Williams &Wilkins. 2014.

Gianturco L, Gianturco V. How do you answer a 65-year-old, without a history of cardiac or vascular disease, when they ask, “Can I participate in competitive sports? ESC E-journal of Cardiology Pracice. 2021; 19.

Chugh SS, Weiss JB. Sudden cardiac death in the older athlete. J Am Coll Cardiol. 2015; 65: 493-502.

Thompson PD, Franklin BA, Balady GJ, Blair SN, Corrado D, Estes NA, 3rd, et al. Exercise and acute cardiovascular events placing the risks into perspective: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism and the Council on Clinical Cardiology. Circulation. 2007; 115: 2358-68.

Braber TL, Mosterd A, Prakken NH, Rienks R, Nathoe HM, Mali WP, et al. Occult coronary artery disease in middle-aged sportsmen with a low cardiovascular risk score: The Measuring Athlete's Risk of Cardiovascular Events (MARC) study. Eur J Prev Cardiol. 2016; 23: 1677-84.

Peñalver JM, Mosca RS, Weitz D, Phoon CK. Anomalous aortic origin of coronary arteries from the opposite sinus: a critical appraisal of risk. BMC Cardiovasc Disord. 2012; 12: 83.

Gowd BM, Thompson PD. Isolated myocardial bridging and exercise-related cardiac events. Int J Sports Med. 2014; 35: 1145-50.

Pelliccia A, Sharma S, Gati S, Bäck M, Börjesson M, Caselli S, et al. 2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease. Eur Heart J. 2021; 42: 17-96.

Mont L, Pelliccia A, Sharma S, Biffi A, Borjesson M, Brugada Terradellas J, et al. Pre-participation cardiovascular evaluation for athletic participants to prevent sudden death: Position paper from the EHRA and the EACPR, branches of the ESC. Endorsed by APHRS, HRS, and SOLAECE. Eur J Prev Cardiol. 2017; 24: 41-69.


Download data is not yet available.


How to Cite
Ito, S. (2022). High-intensity Interval Training for Older Adults: Safety Issues. European Journal of Medical and Health Sciences, 4(1), 3–5. https://doi.org/10.24018/ejmed.2022.4.1.1224