In volume-matched randomized controlled trials, high-intensity interval training consistently produces greater improvements in vascular endothelial function and arterial stiffness compared to moderate-intensity training.
"if you read any of the randomized control trials too just comparing moderate intensity training to high intensity interval training if you look at the effects on endothelial function like you mentioned in artery stiffness it's it's not it doesn't even come close like when even when they're volume matched. So you say you do the same amount of volume of moderate intensity and high intensity interval training. High-intensity interval training always wins in terms of improving vascular function." (said at 0:36:48)
The claim that high-intensity interval training (HIIT) "always wins" and "doesn't even come close" compared to moderate-intensity continuous training (MICT) for improving vascular endothelial function and arterial stiffness overstates the scientific evidence. Systematic reviews and meta-analyses of randomized controlled trials confirm that HIIT generally produces statistically significant, modest advantages over MICT in improving endothelial function (flow-mediated dilation improvements of 1.43% to 2.6% over MICT). However, findings for arterial stiffness are mixed: while a 2025 meta-analysis found a statistically significant reduction in pulse wave velocity favoring HIIT (-0.10 m/s), an earlier meta-analysis found no statistically significant difference between HIIT and MICT for central arterial stiffness. The evidence supports a general benefit of HIIT over MICT, but the effect size is modest rather than overwhelming, and the superiority is not universal across all arterial stiffness measures.
- contradicts: The effect of high Intensity interval training versus moderate intensity continuous traini… (Journal of science and medicine in sport 2019)
"No significant difference was observed for changes to central arterial stiffness between HIIT and MICT." (abstract, conclusions, passage verified)
pubmedfull study (doi) - supports: High-intensity interval training improves the vascular endothelial function comparing mode… (Clinical nutrition ESPEN 2023)
"HIIT improved the FMD with an overall change of %2.6 [(95% CI: 0.82 to 4.377), p = 0.004] compared to the MICT in overweight and obese adults." (abstract, results, passage verified)
pubmedfull study (doi) - supports: Effects of high-intensity interval training vs. moderate-intensity continuous training on … (Archives of gerontology and geriatrics 2025)
"Compared to MICT, HIIT demonstrated a more significant reduction in PWV (-0.10 m/s [95 % CI:0.16 to -0.03], P = 0.005)." (abstract, results, passage verified)
pubmedfull study (doi) - supports: Effect of exercise modality and intensity on endothelial function in patients with cardiov… (European journal of preventive cardiology 2026)
"HIIE outperformed MAE (1.43%; 95% CI: 0.09-2.78)." (abstract, results, passage verified)
pubmedfull study (doi)