PURPOSE: We aimed to determine if yearly repeated exercise training reduces metabolic syndrome (MetS) and the use of medicines to control MetS components. METHODS: Fifty-five MetS individuals were randomized into a TRAIN group that underwent two yearly programs of 16-wk high-intensity interval training or a nonexercising CONT group. We measured the evolution of all five MetS components, cardiorespiratory fitness (assessed by VO2PEAK) and medicine use, at baseline (0 months), mid (12 months), and end-point (24 months). Testing took place 8 months after the last training session to assess the chronic effects of training. RESULTS: Daily physical activity (wristband activity monitors) and calorie intake (3-d nutritional diary) remained similar to baseline at 1 and 2 yr in each group and were not different between groups. Blood triglycerides and glucose concentrations did not significantly vary in any group. However, waist circumference increased only in CONT after 2 yr (107 +/- 2 cm to 111 +/- 3 cm; p = 0.004). Mean arterial pressure decreased in TRAIN (101 +/- 2 mmHg to 94 +/- 2 mmHg; p = 0.002), whereas it remained unchanged in CONT (98 +/- 2 mmHg to 99 +/- 2 mmHg; p = 1.000) after 2 yr. Starting from similar levels at baseline, after 2 yr VO2PEAK was higher (2.32 +/- 0.14 L/min versus 1.98 +/- 0.11 L/min; p = 0.049) and medicine use lower (1.27 +/- 0.22 versus 2.23 +/- 0.43; p = 0.043) in TRAIN than CONT. The reduction in MAP in TRAIN commanded a parallel reduction in MetS z-score from baseline to 2 yr (0.30 +/- 0.1 to 0.07 +/- 0.1; p = 0.013). CONCLUSIONS: Two yearly 16-wk high-intensity interval training programs are enough exercise to chronically lower MetS while preventing the reductions in cardiorespiratory fitness associated to aging. Of clinical relevance, yearly exercise training halts the increase in medicine use that occurs in non-exercising MetS individuals.

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