Associations between change in moderate-to-vigorous physical activity and sedentary behaviour with risk of recurrent cardiovascular events among individuals with coronary heart disease: A prospective cohort study

Area of Science:

• Cardiology
• Preventive Medicine
• Exercise Physiology

Background:

• Secondary prevention of coronary heart disease (CHD) guidelines recommend moderate-to-vigorous physical activity (MVPA) and limiting sedentary behaviour (SB).
• Limited data exists on the impact of changes in MVPA and SB on recurrent cardiovascular events in CHD populations.

Purpose of the Study:

• To investigate the association between changes in MVPA and SB and the occurrence of recurrent cardiovascular events in individuals with CHD.

Main Methods:

• A prospective cohort study involving 9430 Australian adults with CHD.
• MVPA and SB were self-reported; recurrent cardiovascular events were tracked via health registers from 2006-2022.
• Cox proportional regression models analyzed associations between categorized changes in MVPA/SB (remaining high/low, increasing, decreasing) and event risk.

Main Results:

• High MVPA was linked to a 32-39% lower risk of recurrent cardiovascular events compared to low MVPA.
• Increased MVPA reduced total cardiac events by 30% and MACE by 26%; decreased MVPA lowered MACE by 16%.
• Low SB was associated with a 25-29% lower risk of total cardiac events and MACE; decreased SB lowered MACE by 25%.

Conclusions:

• Maintaining high MVPA and low SB levels are vital for secondary prevention in CHD patients.
• Interventions supporting sustained high MVPA and reduced SB are important for improving outcomes in individuals with CHD.