# Feasibility of high-intensity interval training in older adults with HIV and co-occurring hypertension PMID: 41918041 Journal: Pilot and Feasibility Studies Published: 2026-03-31 Authors: Hankes MJ, Taylor TL, Zumbro EL, Enogela EM, Dodds F, Tharpe M, Sint Jago SC, Goodin BR, Willig AL, Buford TW, Jones R ## Question To assess the feasibility, efficacy, and safety of a 6-week HIIT intervention among older people living with HIV and co-occurring hypertension. ## Summary This single-group pilot study tested whether older adults living with HIV and treated hypertension could complete a 6-week, supervised cycling HIIT program. Ten of 13 enrolled participants completed the study. Attendance was high, prescribed high-intensity heart-rate targets were achieved by completers, and no serious adverse events were reported. Blood pressure, BMI, perceived exercise barriers, SPPB score, and 4-meter walk time moved in favorable directions, while 6-minute walk distance declined slightly. Because the study was small, uncontrolled, and designed for feasibility rather than efficacy, the results mainly support feasibility and safety in a supervised clinical exercise setting. ## Population - Older people living with HIV and co-occurring treated hypertension, inactive at baseline, recruited from a local HIV/AIDS clinic. - Sample size: 13 - Age: Completers: 60.5 +/- 4.9 years; inclusion at least 50 years. - Sex: Completers: 60% male, 40% female. - Fitness level: Inactive lifestyle, less than 150 min per week of moderate activity. - Health status: Living with HIV, on ART, virally suppressed among completers, treated hypertension. ## Methodology - Single-group pre-post pilot feasibility intervention study - 6 weeks - University of Alabama at Birmingham Center for Exercise Medicine, recruited from a local HIV/AIDS clinic ## Protocol - Supervised cycling HIIT. - Modality: Upright stationary bike. - Work intervals: 4 min at 80-90% age-predicted HRmax. - Recovery: 3 min active rest at about 60-70% HRmax. - Sets or repetitions: 4 intervals. - Intensity: 80% HRmax progressing to 90% HRmax over 6 weeks; RPE monitored. - Session duration: Up to 45 min including 5-min warm-up and 5-min cool-down. - Frequency: 2 sessions per week. - Program length: 6 weeks. - Progression: Progressive intensity ramp from 80% to 90% HRmax. ## Outcomes ### Feasibility Status: improved Of 26 eligible participants contacted, 13 consented and enrolled; 10 completed the study. Consent rate was 50%, completion was 76.9%, attendance was 86%, and protocol adherence to high-intensity bouts was 100% among completers. Descriptive feasibility outcomes only. ### Exercise perceptions Status: improved EBBS total increased from 135 to 139; Benefits Subscale increased from 94 to 95; Barriers Subscale decreased from 29 to 26. Hedges' g: total EBBS 0.2, Benefits 0.1, Barriers 0.4. ### Blood pressure Status: improved Systolic BP declined from 133.4 +/- 9.0 to 128.1 +/- 9.9 mmHg; diastolic BP declined from 80.2 +/- 6.5 to 76.0 +/- 8.6 mmHg. Systolic difference -5.3 mmHg (95% CI -12.8 to 3.0), Hedges' g 0.5 (95% CI -0.4 to 1.4); diastolic difference -4.2 mmHg (95% CI -11.7 to 2.0), Hedges' g 0.5 (95% CI -0.4 to 1.4). ### BMI Status: improved BMI declined from 33.3 +/- 12.4 to 32.3 +/- 10.8 kg/m2. Difference -1.0 kg/m2 (95% CI -3.1 to 1.1), Hedges' g 0.1 (95% CI -0.9 to 0.8). ### 6-minute walk test Status: worse/safety concern 6MWT distance declined from 419.7 +/- 80.4 to 414.7 +/- 51.6 m. Difference -5.0 m (95% CI -9.7 to 1.0), Hedges' g 0.1 (95% CI -0.8 to 0.9). ### Safety Status: mixed One participant experienced foot pain during exercise sessions; no serious adverse events were reported. ## Practical Insights - A 4 x 4-min cycling HIIT structure twice weekly can be feasible in carefully screened, supervised older adults with HIV and treated hypertension. - Clinical safety evidence from this study depends on supervision, screening, and heart-rate monitoring. - Fatigue, travel distance, time commitment, and pain are important implementation barriers for this population. - The 6MWT decline cautions against assuming all fitness markers improve after a short HIIT program in older PWH. ## Limitations - Small sample size - Single-group pre-post design - No randomization or control group - Single-center recruitment from one HIV clinic - Pilot study not powered or designed for efficacy testing - Limited generalizability to broader HIV populations or unsupervised settings - Mechanistic vascular outcomes were not assessed ## Safety And Adherence - One foot-pain event occurred during exercise sessions. - No serious adverse events were reported. - The study used screening, supervised exercise, continuous heart-rate monitoring, and progressive intensity ramping. ## Original Sources - [PubMed](https://pubmed.ncbi.nlm.nih.gov/41918041/) (pubmed) - [DOI](https://doi.org/10.1186/s40814-026-01812-y) (doi) - [PMC full text](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13162456/) (full text) ## Agent Guidance Preserve the paper-level scope of this note. Do not generalize beyond the population, protocol, measured outcomes, and limitations above.