Sedentary behaviour in cardiovascular disease patients: risk factor identification and the impact of cardiac rehabilitation

Abstract

Abstract Background Cardiovascular disease (CVD) patients typically report low physical activity levels. Therefore sedentary behaviour (SB) is potentially an important target to improve survival and to reduce recurrence risk. However, information about SB in CVD patients is scarce. Purpose In this study, we 1) compared SB between CVD patients and age-matched controls, 2) identified patient- and disease characteristics associated with high SB levels, and 3) determined the impact of contemporary cardiac rehabilitation on SB. Methods For objective 1, we recruited 131 patients and 117 healthy, age-matched individuals. All participants were asked about their general characteristics and medical history. SB was assessed objectively by an accelerometer. For objective 2, 2,584 patients completed a questionnaire about their general characteristics, lifestyle, medical history and their SB. For objective 3, SB was examined before, after and 2 months after cardiac rehabilitation among 131 patients using an accelerometer. Results Objective 1. Patients spent 10.4 hrs/day (Q25 9.5; Q75 11.2) sedentary which was higher compared to healthy controls (9.4 hrs/day [Q25 8.4; Q75 10.29]). Similarly, patients reported more prolonged sedentary bouts (>30 min) compared to controls (5.9 versus 4.8 bouts/day; P<0.001). Objective 2. Patients being male, single or divorced, employed, physically inactive, reporting high alcohol consumption, living in an urban environment, having comorbidities and cardiac anxiety demonstrated a greater odds for large amounts of sedentary time (>8 hrs/day). Objective 3. Cardiac rehabilitation significantly reduced sedentary time (−0.4 hrs/day [95% CI: −0.7; −0.1]), which remained lower at 2 months after cardiac rehabilitation (−0.3 hrs/day [95% CI: −0.6; −0.03]). In addition, prolonged sedentary bouts decreased significantly after cardiac rehabilitation (−0.4 bouts/day [95% CI: −0.7; −0.1]), but this effect diminished within 2 months after the programme (−0.2 bouts/day [95% CI: −0.5; 0.1]). Conclusions CVD patients had greater amounts of objectively measured sedentary time compared to healthy controls, with more frequent engagement in prolonged sedentary bouts. Sedentarism was associated with personal- and lifestyle characteristics, and comorbidities. Participation in a contemporary cardiac rehabilitation programme slightly reduced sedentary time, but tailored interventions are needed to target the high amount of sedentary time in CVD patients. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Dutch Heart Foundation