Even a little daily activity may lower heart, death risks for heart attack survivors
By American Heart Association News
People who spend their days sedentary after a heart-related emergency – such as a heart attack or chest pain – may face a greater risk of another cardiac event or even death within a year than those who move even a little, according to new research.
The study found replacing just 30 minutes of sedentary time with 30 minutes of light-intensity physical activity could lower the risk of having another cardiovascular event or dying by 50%. The risk could be reduced by up to 61% with the same amount of moderate to vigorous physical activity. The findings were published May 19 in the American Heart Association journal Circulation: Cardiovascular Quality and Outcomes.
"Current treatment guidelines after a cardiac event focus mainly on encouraging patients to exercise regularly," lead author Dr. Keith Diaz, an associate professor of behavioral medicine at Columbia University Medical Center in New York City, said in a news release. "In our study, we explored whether sedentary time itself may contribute to cardiovascular risk."
Prior research by the same team found people who had experienced a heart attack were spending up to 13 hours each day being sedentary, defined as getting little to no physical movement during periods when they were awake.
In the new study, researchers analyzed health, sleep and physical activity data for 609 adults, ages 21 to 96, who were treated for a heart attack or chest pain in the emergency department at Columbia University Medical Center. Physical activity was tracked using wrist accelerometers for a median of 30 days following discharge from the hospital.
The devices measured movement in three directions – forward and backward, side to side and up and down – to better assess the intensity of movement beyond what a person could recall. Examples of moderate-intensity physical activities included brisk walking, water aerobics, dancing, doubles tennis and gardening. Vigorous-intensity activity included running, swimming laps, heavy yard work, singles tennis and jumping rope.
People in the most physically active group averaged 143.8 minutes of light daily physical activity, 25 minutes of moderate-to-vigorous activity, 11.7 hours of sedentary behavior and 8.4 hours of sleep. People in the least physically active group averaged 82.2 minutes of light physical activity per day, 2.7 minutes of moderate-to-vigorous activity, 15.6 hours of sedentary behavior and 6.6 hours of sleep.
Phone surveys, electronic health records and the Social Security Death Index were used to determine whether cardiac events or deaths from any cause had occurred up to one year after hospital discharge.
The least active participants were more than 2.5 times as likely as the most active to have another heart attack, have surgery to treat heart issues, be hospitalized again or die within a year of their first cardiac event.
Getting more sleep also lowered the participants' risk for another cardiovascular event or death. Swapping 30 minutes of sedentary behavior for 30 minutes of sleep reduced the risk by 14%.
"We were surprised that replacing sedentary time with sleep also lowered risk," said Diaz, a certified exercise physiologist. "Sleep is a restorative behavior that helps the body and mind recover, which is especially important after a serious health event like a heart attack."
During the follow-up period, 50 participants – about 8% – experienced another cardiac event or died.
The findings indicate "that one doesn't have to start running marathons after a cardiovascular event to see benefits," Diaz said. "Sitting less and moving or sleeping a little more can make a real difference."
Even small tasks, such as tidying up the house or a slow stroll were "nearly as beneficial as moderate-to-vigorous-intensity physical activities, like biking or doing aerobics," Dr. Bethany Barone Gibbs said in the news release. She is chair of the department of epidemiology and biostatistics at the School of Public Health at West Virginia University in Morgantown.
The study provides more support for a "sit less, move more" strategy for people who experienced a heart event – and especially those who may have barriers to more intense exercise, said Barone Gibbs, who was not involved in the research.
"These findings suggest sitting less and doing anything else – like taking a walk, cooking, playing with your dog or gardening – will help you stay healthier," she said.