HIIT is a term that gets watered down a bit much. Originally it was mostly used for something where you'd nearly die from as the effort put into it was so much, and when HIIT got popular the term gets thrown around a bit too loosely.
Using a mix of RPE & HR is good. However, with this particular person it seems best to establish at what particular HR he is exerting himself to the level that he can still talk, but with some effort. I'm amazed and even appalled his former trainer had him put on a certain HR zone without even checking whether that zone was correct for him.
Good for you to check out if his difficulty with achieving that HR and having a lowish RHR might be due to his medication.
But like I said before, a low HR might be just as normal for him as it is for me. 160bpm would definitely be out of the question, unless it'd be raised artificially due to extreme stress.. (have seen such high HR only at the start of a mass event where speed did matter = 5000 cyclists around me at the same time)
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