What is the clinical evidence from this study?

Study design: Cohort. Population: Coronary heart disease (n=67). Intervention: Device-measured physical activity and sedentary behaviour vs. Lower levels of physical activity or sedentary behaviour. Primary outcome: High-density lipoprotein (HDL) (β -0.002, 95% CI -0.003 to -0.001, p=<0.001).

September 7, 2022Open Access

Association of device-measured physical activity and sedentary behaviour with cardiovascular risk factors, health-related quality-of-life and exercise capacity over 12-months in cardiac rehabilitation attendees with coronary heart disease

Q: What are the key findings of this study?

In cardiac rehabilitation attendees, higher moderate-to-vigorous physical activity was associated with a statistically significant but clinically negligible decrease in high-density lipoprotein over time.

NFNicole FreeneUniversity of Canberra MMMargaret McManusAct Health TMTarryn MairAct Health

Resultado clave

In cardiac rehabilitation attendees, higher moderate-to-vigorous physical activity was associated with a statistically significant but clinically negligible decrease in high-density lipoprotein over time.

Diseño del estudio

Tipo

Cohort (n=67)

Multicéntrico

PICO estructurado

Does device-measured physical activity and sedentary behaviour associate with cardiovascular risk factors, health-related quality-of-life, and exercise capacity over 12 months in cardiac rehabilitation attendees with coronary heart disease?

Población

67 adults (mean age 64, 19% female) with stable coronary heart disease attending a 6-week cardiac rehabilitation program, followed for 12 months.

Exposición

Device-measured physical activity (moderate-to-vigorous [MVPA] and light-intensity [LIPA]) and sedentary behaviour (bouts, breaks) assessed using an ActiGraph accelerometer over 12 months.

Resultado

Association of physical activity and sedentary behaviour with cardiovascular risk factors (waist circumference, BMI, systolic blood pressure, fasting blood lipid and glucose levels, anxiety and depression), health-related quality-of-life (MacNew Global), and exercise capacity (6MWTD) over 12 months.surrogate

In cardiac rehabilitation attendees, any intensity of physical activity is associated with decreased total cholesterol, while increased light-intensity physical activity improves adiposity measures and breaking up sedentary behavior may decrease systolic blood pressure over time.

Resultado numérico

Estimación del efecto: β -0.002 (95% CI -0.003 to -0.001)

valor p: p=<0.001

Limitaciones

A high percentage of participants did not have complete accelerometer data.
Participants were predominantly highly educated males with normal baseline risk factors, limiting generalizability.
Possible dilution effect for the accelerometer data due to the averaging of data and the application of a time filter.
The accelerometer cut-points used may not be appropriate for cardiac rehabilitation participants.

Resumen

BACKGROUND: Few studies have considered the relationship between risk factors, physical activity and sedentary behaviour in people with heart disease. Here we examine the independent relationship of device-measured physical activity and sedentary behaviour on risk factors, quality-of-life and exercise capacity over 12-months in cardiac rehabilitation attendees. METHODS: Hospital-based phase II cardiac rehabilitation participants with coronary heart disease were assessed at the start and end of cardiac rehabilitation (6-weeks), 6 and 12-months. Physical activity (moderate-to-vigorous (MVPA), light-intensity (LIPA); min/day) and sedentary behaviour (min/day, bouts, breaks) were measured using an ActiGraph accelerometer. Risk factors included waist circumference, body mass index, systolic blood pressure (SBP), fasting blood lipid and glucose levels, anxiety and depression. Quality-of-life and exercise capacity were also collected. Associations were assessed with Generalized Estimating Equation modeling. RESULTS: Sixty-seven participants were included (mean age = 64 (SD 9) years; 81% male). An association was found between higher MVPA and lower high density lipoprotein (p ≤ 0.001). No significant (p ≤ 0.001) associations were found between sedentary behaviour variables and other outcomes. At p < 0.05 several associations were significant. Increased MVPA and LIPA were associated with decreased total cholesterol. Higher MVPA was associated with decreased SBP, whereas higher LIPA was associated with decreased waist circumference and body mass index. Higher sedentary behaviour bouts and breaks were associated with increased total cholesterol, anxiety and depression, and decreased SBP over time. CONCLUSIONS: Any intensity of physical activity was associated with decreased total cholesterol. Increased LIPA was associated with improved measures of adiposity, while breaking up sedentary behaviour and increasing MVPA may decrease SBP over time. Further investigation of MVPA, LIPA and the distribution of sedentary behaviour is indicated in cardiac rehabilitation attendees to explore their relationship with risk factors. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12615000995572, http://www.ANZCTR.org.au/ACTRN12615000995572.aspx . Registered 22 September 2015.

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