The Impact of High‑Intensity Interval Training Versus Moderate‑Intensity Continuous Training on Carotid Intima‑Media Thickness and Ankle‑Brachial Index in Middle‑Aged Women

Samaneh Farahati, Seyyed Reza Attarzadeh Hosseini, Mahtab Moazzami, Mahdi Hasanzadeh Daloee, Shima Hasanzadeh Daloee


Objective: Obesity has been linked to cardiovascular risk factors characterized by endothelial dysfunction and arterial wall thickening. Regular exercise training is recognized as a powerful tool to improve endothelial function and cardiovascular risk profile, but it is unknown which of high‑intensity interval training or moderate‑intensity continuous training is the best exercise.

Materials and Methods: A total of 33 inactive and overweight women aged 40–50 years old and body mass index >27 kg/m2 were randomized to high‑intensity interval training, moderate‑intensity continuous training, or control. The exercise intervention consisted of 12 weeks of training and three supervised sessions per week. The moderate‑intensity group was trained continuously for 47 min at 60–70% of maximal heart rate. High‑intensity interval training consisted of four interval bouts of 4 min at 85%–95% of maximal heart rate with 3 min breaks at 50%–60% of maximal heart rate between the intervals. For all analyses, statistical significance was assigned at P < 0.05.

Results: According to our findings, while carotid intima‑media thickness decreased in both training groups, this reduction was not statistically significant. In the high‑intensity training group, the right ankle‑brachial index increased significantly (P = 0.007).

Conclusion: Twelve weeks of exercise training, especially in high‑intensity interval training, have led to improving lipid profiles and endothelial function, it can be said that regular and prolonged exercise can probably be a preventive
factor in cardiovascular disease in overweight women.

Keywords: Atherosclerosis, high‑intensity interval training, overweight, vascular stiffness

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Boardley D, Pobocik RS. Obesity on the rise. Prim Care


Mikirova NA, Casciari JJ, Hunninghake RE, M Beezley M.

Effect of weight reduction on cardiovascular risk factors and

CD34‑positive cells in circulation. Int J Med Sci 2011;8:445‑52.

Ha Park K, Jung Park W. Endothelial dysfunction: Clinical

implications in cardiovascular disease and therapeutic

approaches. J Korean Med Sci 2015;30:1213‑25.

Iantorno M, Campia U, Di Daniele N, Nistico S, Forleo GB,

Cardillo C, et al. Obesity, inflammation and endothelial

dysfunction. J Biol Regul Homeost Agents 2014;28:169‑76.

Bots ML, Hoes AW, Koudstaal PJ, Hofman A, Grobbee DE.

Common carotid intima‑media thickness and risk of stroke

and myocardial infarction: The Rotterdam Study. Circulation


Chambless LE, Heiss G, Folsom AR, Rosamond W, Szklo M,

Sharrett AR, et al. Association of coronary heart disease

incidence with carotid arterial wall thickness and major risk

factors: The Atherosclerosis Risk in Communities (ARIC) Study

‑1993. Am J Epidemiol 1997;146:483‑94.

Momeni A, Dyani MA, Ebrahimi E, Sedehi M, Naderi A.

Association of retinopathy and intima media thickness of

common carotid artery in type 2 diabetic patients. J Res Med Sci


Allameh Z, Rouholamin S, Adibi A, Mehdipour M, Adeli M.

Does carotid intima‑media thickness have relationship with

polycystic ovary syndrome?. Int J Prev Med 2013;4:1266‑70.

Allison MA, Ho E, Denenberg JO, Langer RD, Newman AB,

Fabsitz RR, et al. Ethnic‑specific prevalence of peripheral arterial

disease in the United States. Am J Prev Med 2007;32:328‑33.

McDermott MM, Greenland P, Liu K, Guralnik JM, Celic L,

Criqui MH, et al. The ankle brachial index is associated with leg

function and physical activity: The Walking and Leg Circulation

Study. Ann Intern Med 2002;136:873‑83.

Heald CL, Fowkes FG, Murray GD, Price JF. Risk of mortality

and cardiovascular disease associated with the ankle‑brachial

index: Systematic review. Atherosclerosis 2006;189:61‑9.

Maeda Y, Inoguchi T, Tsubouchi H, Sawada F, Sasaki S, Fujii M,

et al. High prevalence of peripheral arterial disease diagnosed by

low ankle‑brachial index in Japanese patients with diabetes: The

Kyushu Prevention Study for Atherosclerosis. Diabetes Res Clin

Pract 2008;82:378‑82.

Li J, Luo Y, Xu Y, Yang J, Zheng L, Hasimu B, et al. Risk

factors of peripheral arterial disease and relationship between

low ankle‑brachial index and mortality from all‑cause and

cardiovascular disease in Chinese patients with type 2 diabetes.

Circ J 2007;71:377‑81.

Makhdoomi K, Mohammadi A, Yekta Z, Aghasi MR, Zamani N.

Atherosclerotic screening with ankle‑brachial index in type 2

diabetes mellitus and its correlation with other factors. J Urmia

Univ Med Sci 2012;23:52‑8.

Goto C, Higashi Y, Kimura M, Noma K, Hara K,

Nakagawa K, et al. Effect of different intensities of exercise

on endothelium‑dependent vasodilation in humans: Role of

endothelium‑dependent nitric oxide and oxidative stress. Circ J


Ramos JS, Dalleck LC, Tjonna AE, Beetham KS,

Coombes JS. The impact of high‑intensity interval training

versus moderate‑intensity continuous training on vascular

function: A systematic review and meta‑analysis. Sports Med


Vion AC, Ramkhelawon B, Loyer X, Chironi G, Devue C,

Loirand G, et al. Shear stress regulates endothelial microparticle

release. Circ Res 2013;112:1323‑33.

Stein JH, Korcarz CE, Hurst RT, Lonn E, Kendall CB,

Mohler ER, et al. Use of carotid ultrasound to identify

subclinical vascular disease and evaluate cardiovascular disease

risk: A consensus statement from the American Society of

Echocardiography Carotid Intima‑Media Thickness Task Force.

Endorsed by the Society for Vascular Medicine. J Am Soc

Echocardiogr 2008;21:93‑111.

Al‑Qaisi M, Nott DM, King DH, Kaddoura S. Ankle brachial

pressure index (ABPI): An update for practitioners. Vasc Health

Risk Manag 2009;5:833‑41.

Schjerve IE, Tyldum GA, Tjønna AE, Stølen T, Loennechen JP,

Hansen HE, et al. Both aerobic endurance and strength training

programs improve cardiovascular health in obese adults. Clin Sci


Moreau KL, Donato AJ, Seals DR, Dinenno FA, Blackett SD,

Hoetzer GL, et al. Arterial intima‑media thickness: Site‑specific

associations with HRT and habitual exercise. Am J Physiol Heart

Circ Physiol 2002;283:H1409‑17.

Tanaka H, Seals DR, Monahan KD, Clevenger CM,

DeSouza CA, Dinenno FA. Regular aerobic exercise and the

age‑related increase in carotid artery intima‑media thickness in

healthy men. J Appl Physiol 2002;92:1458‑64.

Gelinas JCM. The effects of aerobic exercise training on peripheral

vascular structure and function and inflammation in patients with

chronic obstrutive pulmonary disease [Master of Science Thesis].

The University of British Columbia, Canada; 2013.

Rakobowchuk M, Tanguay S, Burgomaster KA, Howarth KR,

Gibala MJ, MacDonald MJ. Sprint interval and traditional

endurance training induce similar improvements in

peripheral arterial stiffness and flow‑mediated dilation in

healthy humans. Am J Physiol Regul Integr Comp Physiol


Gibbs BB, Dobrosielski DA, Althouse AD, Stewart KJ. The

effect of exercise training on ankle‑brachial index in type 2

diabetes. Atherosclerosis 2013;230:125‑30.

Poblete Aro CE, Russell Guzmán JA, Soto Muñoz ME, Villegas

González BE. Effects of high intensity interval training versus

moderate intensity continuous training on the reduction of

oxidative stress in type 2 diabetic adult patients: CAT. Medwave


Huttunen JK. Physical activity and plasma lipids and lipoproteins.

Ann Clin Res 1982;(14 Suppl) 34:124‑9.

Mann S, Beedie C, Jimenez A. Differential effects of aerobic

exercise, resistance training and combined exercise modalities

on cholesterol and the lipid profile: Review, synthesis and

recommendations. Sports Med 2013;44:211‑21.