Physical activity and glycemic control among adults living with coronary heart disease

Abstract

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): University of Akureyri Research Fund Landspitali University Hospital Science Fund Background The most common comorbidity in coronary heart disease (CHD) is diabetes mellitus (DM). The presence of DM or pre-diabetes mellitus in addition to CHD further increases health risks. Engagement in regular physical activity (PA) has been shown to improve health and well-being and increase life expectancy. For that reason, it is important to explore the role of PA when the diseases coexist and how PA can be used effectively as part of treatment to improve coronary patients’ health. Purpose The aim of the study was to explore the relationship between the level of PA and glycemic control in adults with CHD. Methods This study had a cross-sectional design. The participants were adults who had been admitted to one of two main hospitals in Iceland between October 2017 and November 2018 following a CHD incident. Data was collected six months after hospital discharge with questionnaires, physical measurements, blood samples, and from medical files. The Leisure-Time Physical Activity Questionnaire was used to measure PA. The participants were categorized into four groups according to their PA level (mostly sedentary; light; moderate; or high PA) and the relationship between PA levels and long-term glycemic control (glycated hemoglobin percentage (HbA1c%)) was explored using one-way ANOVA with Tukey post-hoc test. Results The sample consisted of 346 individuals. Their mean age was 64.6 years (SD = 8.9), 80.1% were males and 20.9% had diabetes. The mean HbA1c% was 5.9% (SD = 0.9; range = 4.6%-12.8%). The PA questionnaire classified 15.1% of the participants as mostly sedentary, 43.6% engaged in light PA, 33.2% engaged in moderate PA and 8.1% engaged in high levels of PA (Figure 1). An analysis of variance revealed a significant difference in mean HbA1c% values between groups F(3, 343) = 8.56, p < 0.001. Post-hoc comparisons showed that the mean HbA1c% of the least active individuals (M = 6.4%, SD = 1.5) was significantly higher than in all other groups. However, there were no significant group differences between those who engaged in light PA (M = 5.8%, SD = 0.7), moderate PA (M = 5.8%, SD = 0.6) and high levels of PA (M = 5.7%, SD = 0.8), (Figure 2). Conclusion PA was associated with small benefits in glycemic control among individuals with CHD. These findings emphasize the importance of PA in the treatment and management of CHD, and indicate that even small amounts of PA may be of value.Figure 1:Distribution of PA levelsFigure 2:HbA1c% according to PA level L