- The study compares exercise modalities in more than 6,800 patients with cardiovascular diseases
- Training intensity and structure are key to improving cardiac rehabilitation and quality of life
Alicante (04.05.26).– Researchers from the Alicante Institute for Health and Biomedical Research (ISABIAL) and the Miguel Hernández University of Elche (UMH) have shown that exercise based on high‑intensity intervals with periods of rest—high‑intensity interval training—is the most effective way to improve blood vessel health in people with cardiovascular diseases.
The study, recently published in the scientific journal European Journal of Preventive Cardiology, provides new evidence to optimise cardiac rehabilitation programmes.
To do so, the research team analysed 37 studies involving a total of 6,818 adult patients with coronary artery disease or heart failure. The work compares three major types of exercise: continuous moderate‑intensity aerobic activity, high‑intensity interval training, and combined programmes that include strength training.
The Key Role of Intensity
The lead researcher of the ISABIAL Physical Exercise for Health group and UMH professor, José Manuel Sarabia, explained that ‘blood vessels are lined by an inner layer called the endothelium, which is essential for their proper functioning. This layer allows the vessels to dilate and adapt to blood flow’.
“When the endothelium deteriorates—something common in cardiovascular diseases and the leading cause of death worldwide—the vessels lose flexibility and the risks of inflammation and clot formation increase”, he added.
The study concluded that high‑intensity interval training is the modality that achieves the most consistent improvement in this vascular function. ‘This type of exercise forces blood vessels to adapt quickly to changes in blood flow and pressure, which trains their response capacity. It is a more comprehensive workout for vessels that need to regain flexibility’, explained Dr. Sarabia.
Laura Fuertes Kenneally, cardiologist at the Alicante General University Hospital, ISABIAL researcher and first author of the study, pointed out that ‘not all exercise has the same effect on cardiovascular health, and aspects such as intensity or the way training is structured are key to achieving real benefits’.
Dr. Fuertes also added that ‘these results may be useful for designing more effective and patient‑tailored cardiac rehabilitation programmes’. She does, however, warn that this type of exercise ‘must always be performed under professional supervision and adjusted to each person’s condition’.
These findings are especially relevant for people with cardiovascular diseases, as better blood vessel function is associated with a lower risk of complications and an improved quality of life.
The study was co‑led by researcher Agustín Manresa Rocamora and included the participation of researchers Sabina Baladzhaeva, Noemí Sempere Ruiz and Ana Sanz Rocher, together with researcher Carles Blasco Peris.
The research was funded with public support from the Generalitat Valenciana, the Ministry of Science, Innovation and Universities, the Carlos III Health Institute, and the European Union.
Access to the article: Fuertes‑Kenneally, L., Baladzhaeva, S., Manresa‑Rocamora, A., Sempere‑Ruiz, N., Sanz‑Rocher, A., Blasco‑Peris, C., & Sarabia, J. M. (2026). Effect of exercise modality and intensity on endothelial function in patients with cardiovascular disease: a systematic review and network meta‑analysis. European Journal of Preventive Cardiology, zwag118. https://doi.org/10.1093/eurjpc/zwag118
