Study identifies who skips exercise after heart attack—and why
Swedish researchers tracked 1,500 heart disease patients and found that age, income, and other health conditions strongly predict whether they'll exercise. The findings could help hospitals target at-risk patients for intervention programs, potentially reducing expensive readmissions and improving long-term survival rates.
Originaltitel: Associations of demographic, socioeconomic, lifestyle factors and comorbidity with accelerometer-measured physical activity in adults with cardiovascular diseases.
Inköpschefer och regionala vårdgivare kan använda resultaten för att utforma målriktade rehabiliteringsprogram och accelerometerbaserad övervakning av fysisk aktivitet hos patienter med hjärt-kärlsjukdom. En svensk kohortstudie med 1 484 patienter (32 procent kvinnor, medianålder 60,2 år) mätte fysisk aktivitet via höftmonterad accelerometer under sju dagar. Resultat visade att rökning, kvinnligt kön, högre ålder och förekomst av andra sjukdomar starkt minskade sannolikheten för måttlig till intensiv aktivitet. En patient med en comorbiditet hade 39 procent lägre odds för högre aktivitetsnivå jämfört med friska. Däremot ökade hälsosam diet oddsen för högre aktivitet med 84 procent. Ekonomisk press, utbildning och alkoholkonsumption påverkade inte. Karolinska Institutet ledde forskningen tillsammans med svenska universitet. För regionvården innebär detta att interventioner bör fokusera på rökavvänjning, kostomställning och individualiserad träning för patienter med multisjuklighet — områden där förbättring är möjlig.
Cardiovascular diseases (CVDs) are a leading cause of morbidity and mortality, and physical activity (PA) is central to secondary prevention. However, factors associated with PA among individuals with CVDs remain poorly understood, with few studies using accelerometer-based methods. This cross-sectional study examined the associations between accelerometer-measured PA and demographic, socioeconomic, lifestyle factors, and comorbidity in a large Swedish cohort of individuals with CVDs. Participants aged between 50 and 64 years with a confirmed diagnosis of angina pectoris, myocardial infarction, atrial fibrillation and flutter, heart failure, or stroke were included. Moderate-to-vigorous physical activity was measured using hip-worn triaxial accelerometers over seven consecutive days and categorized into tertiles of low, medium and high PA level. Demographic, socioeconomic, lifestyle factors, and comorbidities were assessed through questionnaires and registry data. Associations with PA levels were analyzed using multiple ordinal logistic regression. A total of 1,484 participants (32% women; median age 60.2 years) were included. Being in the oldest age group was significantly associated with lower odds of having a higher PA level (OR = 0.59; 95% CI [0.44, 0.77]), as well as female sex (OR = 0.73; 95% CI [0.59, 0.91]), regular/occasional smoking (OR = 0.37; 95% CI [0.26, 0.52]), and having one (OR = 0.61; 95% CI [0.48, 0.77]) or more comorbidities (OR = 0.45; 95% CI [0.30, 0.68]). A healthy diet was significantly associated with higher PA levels (OR = 1.84; 95% CI [1.46, 2.31]). Financial strain, level of education and alcohol consumption had no association with PA. Using data from a representative sample of middle-aged adults, the findings indicate that engagement in PA is primarily associated with lifestyle factors, demographic characteristics, and comorbidity. These identified characteristics may inform future research aimed at CVD populations with low PA. Further research should investigate mediating and moderating pathways to clarify how these factors influence PA.