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Published on: March 7, 2019
Physical Activity and Sedentary Behaviour Thresholds for Secondary Prevention of Coronary Heart Disease: Morbidity
Amanda Lönn1, Theo Niyonsenga2, Suzanne J Carroll2
1Department of Physical Activity and Health, Swedish School of Sport and Health Sciences, Stockholm, Sweden; Health Research Institute, University of Canberra, Bruce, ACT, Australia.
Insights
For coronary heart disease (CHD) patients, achieving 94-122 min/wk of moderate-to-vigorous physical activity (MVPA) and limiting sedentary behaviour (SB) to 4-10 h/d can reduce cardiovascular event risk.
Area of Science:
- Cardiology
- Exercise Physiology
- Public Health
Background:
- No current guidelines exist for physical activity and sedentary behavior in coronary heart disease (CHD) patients.
- This study identified optimal thresholds for moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB) to mitigate cardiovascular risk.
Purpose of the Study:
- To determine specific MVPA and SB thresholds associated with reduced cardiovascular events in individuals with CHD.
- To inform tailored physical activity recommendations for CHD management.
Main Methods:
- A cohort study of 40,156 Australians with CHD (2006-2022).
- Self-reported MVPA and SB data were collected.
- Survival tree analysis and Cox regression identified risk thresholds for cardiovascular events.
Main Results:
- Lower MVPA thresholds (94-122 min/wk) were linked to reduced nonfatal cardiac events, total cardiac events, and MACE.
- Sedentary behavior thresholds (4-10 h/d) were associated with decreased risk of total cardiac events and MACE.
- Significant sex-specific differences in MVPA and SB thresholds were observed.
Conclusions:
- Identified MVPA thresholds (94-122 min/wk) are lower than general public health guidelines (150 min/wk) for CHD patients.
- Optimal SB levels for reducing cardiovascular risk range from 4 to 10 hours per day.
- These findings support the development of personalized physical activity and sedentary behavior guidelines for individuals with CHD.
Background:
There are no diagnosis-specific guidelines for moderate-to-vigorous physical activity (MVPA) and sedentary behaviour (SB) for coronary heart disease (CHD). This study aimed to identify thresholds of MVPA and SB associated with cardiovascular events.
Methods:
This cohort study included individuals with CHD. MVPA and SB were self-reported, and health registries identified cardiovascular events in the years 2006-2022. Survival tree analyses identified thresholds of time associated with the risk of cardiovascular events. Thresholds were explored with the use of Cox regression models.
Results:
There were 40,156 Australians, mean age 70 years, 62% men. Over a median 8.3 years, 3260 nonfatal cardiac events, 5161 total cardiac events, and 14,383 major adverse cardiovascular events (MACE) occurred. Thresholds for MVPA were 122 min/wk for nonfatal cardiac events and 94 min/wk for total cardiac events and MACE. Meeting MVPA thresholds was associated with an 18% lower risk for nonfatal cardiac events, 29% lower risk of total cardiac events, and 23% lower risk of MACE than not reaching the thresholds. Thresholds for SB were 4 and 10 h/d, respectively, for risk of total cardiac events and MACE. SB below thresholds was associated with a 14% lower risk of total cardiac events and an 18% lower risk of MACE. There were sex-specific thresholds for MVPA and SB.
Conclusions:
To lower cardiovascular event risk, identified MVPA thresholds were lower (94-122 min/wk) than the public health guidelines (150 min/wk) in individuals with CHD. The SB thresholds associated with a lower risk of total cardiac events and MACE varied from 4 to 10 h/d.
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