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Abstract

Aims

Despite the benefits of regular physical activity participation following acute myocardial infarction, little is known about gender differences in physical activity among patients after acute myocardial infarction. We described, by gender, physical activity trajectories pre- and post-acute myocardial infarction, and determined whether gender was independently associated with physical activity.

Methods and results

The Variation in Recovery: Role of Gender on Outcomes of Young AMI patients (VIRGO) study, conducted at 103 US, 24 Spanish, and three Australian hospitals, was designed, in part, to evaluate gender differences in lifestyle behaviors following acute myocardial infarction. We used baseline, one-month, and 12-month data collected from patients aged 18–55 years (n = 3572). Patients were assigned to American Heart Association-defined levels of physical activity. A generalized estimating equation model was used to account for repeated measures within the same individual over time. Men were more active (≥150 min/wk moderate or ≥75 min/wk vigorous activity) than women at baseline (42% vs 34%), one month (45% vs 34%), and 12 months (48% vs 36%) (all p < 0.0001). Men engaged in a significantly longer duration of activity at each time point. When controlling for all other factors, women had 1.37 times the odds of being less active than men from pre-acute myocardial infarction to 12-months post-acute myocardial infarction (95% confidence interval: 1.21–1.55). Non-white race, non-active workplaces, smoking, diabetes, hypertension, and obesity were also associated independently with being less active over time (all p < 0.05).

Conclusions

Although activity increased modestly over time, women recovering from acute myocardial infarction were less likely to meet physical activity recommendations than were men. By identifying factors associated with low levels of activity during acute myocardial infarction recovery, targeted interventions can be introduced prior to hospital discharge.

Keywords

Exercise myocardial infarction risk factors women

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References

Vaccarino

Parsons

Peterson

. Sex differences in mortality after acute myocardial infarction: Changes from 1994 to 2006. Arch Intern Med 2009; 169: 1767–1774.

Izadnegahdar

Singer

Lee

. Do younger women fare worse? Sex differences in acute myocardial infarction hospitalization and early mortality rates over ten years. J Womens Health (Larchmt) 2014; 23: 10–17.

Gupta

Wang

Spertus

. Trends in acute myocardial infarction in young patients and differences by sex and race, 2001 to 2010. J Am Coll Cardiol 2014; 64: 337–345.

Dreyer

Wang

Strait

. Gender differences in the trajectory of recovery in health status among young patients with acute myocardial infarction: Results from the VIRGO study. Circulation 2015; 131: 1971–1980–1971–1980.

Bao

Strait

. Sex differences in perceived stress and early recovery in young and middle-aged patients with acute myocardial infarction. Circulation 2015; 131: 614–623.

Wilmot

O’Flaherty

Capewell

. Coronary heart disease mortality declines in the United States from 1979 through 2011: Evidence for stagnation in young adults, especially women. Circulation 2015; 132: 997–1002.

Jolliffe J, Rees K, Taylor RR, et al. Exercise based rehabilitation for coronary heart disease. The Cochrane Library 2001.

Taylor

Brown

Ebrahim

. Exercise-based rehabilitation for patients with coronary heart disease: Systematic review and meta-analysis of randomized controlled trials. Am J Med 2004; 116: 682–692.

Heran BS, Chen JM, Ebrahim S, et al. Exercise-based cardiac rehabilitation for coronary heart disease. The Cochrane Library 2011.

10.

Shiroma

Lee

I-M

. Physical activity and cardiovascular health: Lessons learned from epidemiological studies across age, gender, and race/ethnicity. Circulation 2010; 122: 743–752.

11.

Dunlay

Pack

Thomas

. Participation in cardiac rehabilitation, readmissions, and death after acute myocardial infarction. Am J Med 2014; 127: 538–546.

12.

Shah

Murthy

Colangelo

. Association of fitness in young adulthood with survival and cardiovascular risk: The coronary artery risk development in young adults (cardia) study. JAMA Intern Med 2015; 176: 87–95.

13.

Benda

Hopman

van Dijk

. Impact of prolonged walking exercise on cardiac structure and function in cardiac patients versus healthy controls. Eur J Prev Cardiol 2016; 23: 1252–1260.

14.

Smedt

Clays

Annemans

. The association between self-reported lifestyle changes and health-related quality of life in coronary patients: The EUROASPIRE III survey. Eur J Prev Cardiol 2014; 21: 796–805.

15.

Briffa

Maiorana

Sheerin

. Physical activity for people with cardiovascular disease: Recommendations of the National Heart Foundation of Australia. Med J Aust 2006; 184: 71–75.

16.

Leon

Franklin

Costa

. Cardiac rehabilitation and secondary prevention of coronary heart disease: An American Heart Association scientific statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity), in collaboration with the American association of Cardiovascular and Pulmonary Rehabilitation. Circulation 2005; 111: 369–376.

17.

Perk

De Backer

Gohlke

. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice. Eur Heart J 2012; 33: 1635–1701.

18.

Steg

James

Atar

. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. The Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC). Eur Heart J 2012; 33: 2569–2619–2569–2619.

19.

Roffi

Patrono

Collet

J-P

. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). 2016; 37: 267–315.

20.

Schairer

Keteyian

Ehrman

. Leisure time physical activity of patients in maintenance cardiac rehabilitation. J Cardiopulm Rehabil 2003; 23: 260–265.

21.

Blanchard

Rodgers

Courneya

. Self-efficacy and mood in cardiac rehabilitation: Should gender be considered? Behav Med 2002; 27: 149–160.

22.

Jason

McGannon

Blanchard

. A systematic gender-based review of physical activity correlates in coronary heart disease patients. Int Rev Sport Exerc Psychol 2015; 8: 1–23.

23.

Ayabe

Brubaker

Dobrosielski

. The physical activity patterns of cardiac rehabilitation program participants. J Cardiopulm Rehabil 2004; 24: 80–86.

24.

Blanchard

Reid

Morrin

. Demographic and clinical determinants of moderate to vigorous physical activity during home-based cardiac rehabilitation: The home-based determinants of exercise (HOME) study. J Cardiopulm Rehabil Prev 2010; 30: 240–245.

25.

Dolansky

Stepanczuk

Charvat

. Women’s and men’s exercise adherence after a cardiac event: Does age make a difference? Res Gerontol Nurs 2010; 3: 30–38.

26.

Smolina

Wright

Rayner

. Long-term survival and recurrence after acute myocardial infarction in England, 2004 to 2010. Circ Cardiovasc Qual Outcomes 2012; 5: 532–540.

27.

Blanchard

McSweeney

Giacomantonio

. Distinct trajectories of light and moderate to vigorous physical activity in heart disease patients: Results from the Activity Correlates afTer cardIac hospitalizatiON (ACTION) trial. J Sci Med Sport 2014; 17: 72–77.

28.

Suaya

Shepard

Normand

S-LT

. Use of cardiac rehabilitation by Medicare beneficiaries after myocardial infarction or coronary bypass surgery. Circulation 2007; 116: 1653–1662.

29.

Blanchard

Reid

Morrin

. Barrier self-efficacy and physical activity over a 12-month period in men and women who do and do not attend cardiac rehabilitation. Rehabil Psychol 2007; 52: 65–73.

30.

Yates

Price-Fowlkes

Agrawal

. Barriers and facilitators of self-reported physical activity in cardiac patients. Res Nurs Health 2003; 26: 459–469.

31.

Centers for Disease Control and Prevention. Receipt of cardiac rehabilitation services among heart attack survivors–19 states and the District of Columbia, 2001. MMWR Morb Mortal Wkly Rep 2003; 52: 1072–1075.

32.

Bethell

Lewin

Evans

. Outpatient cardiac rehabilitation attendance in England: Variability by region and clinical characteristics. J Cardiopulm Rehabil Prev 2008; 28: 386–391.

33.

Marcus

Williams

Dubbert

. Physical activity intervention studies: What we know and what we need to know: A scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity); Council on Cardiovascular Disease in the Young; and the Interdisciplinary Working Group on Quality of Care and Outcomes Research. Circulation 2006; 114: 2739–2752.

34.

Lichtman

Lorenze

D'Onofrio

. Variation in recovery: Role of gender on outcomes of young AMI patients (VIRGO) study design. Circ Cardiovasc Qual Outcomes 2010; 3: 684–693.

35.

Centers for Disease Control and Prevention. Behavioral risk factor surveillance system user's guide, Atlanta, GA: U.S. Centers for Disease Control and Prevention, 1998.

36.

Yore

Ham

Ainsworth

. Reliability and validity of the instrument used in BRFSS to assess physical activity. Med Sci Sports Exerc 2007; 39: 1267–1274.

37.

Evenson

McGinn

. Test-retest reliability of adult surveillance measures for physical activity and inactivity. Am J Prev Med 2005; 28: 470–478.

38.

Haskell

Lee

Pate

. Physical activity and public health: Updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation 2007; 116: 1081–1093.

39.

Department of Health and Human Services. Physical Activity Guidelines Advisory Committee. Physical Activity Guidelines Advisory Committee Report, Washington, DC: U.S. Department of Health and Human Services, 2008.

40.

Brown

Balluz

Heath

. Associations between recommended levels of physical activity and health-related quality of life. Findings from the 2001 Behavioral Risk Factor Surveillance System (BRFSS) survey. Prev Med 2003; 37: 520–528.

41.

Reid

Morrin

Pipe

. Determinants of physical activity after hospitalization for coronary artery disease: The Tracking Exercise After Cardiac Hospitalization (TEACH) study. Eur J Cardiovasc Prev Rehabil 2006; 13: 529–537.

42.

Piepoli

Corrà

Dendale

. Challenges in secondary prevention after acute myocardial infarction: A call for action. Eur J Prev Cardiol 2016. DOI: 10.1177/2047487316663873.

43.

Healy

Dunstan

Salmon

. Breaks in sedentary time: Beneficial associations with metabolic risk. Diabetes Care 2008; 31: 661–666.

44.

Neuhaus

Eakin

Straker

. Reducing occupational sedentary time: A systematic review and meta-analysis of evidence on activity-permissive workstations. Obes Rev 2014; 15: 822–838.

45.

Rajotte

Jean

Baker

. Community-based exercise program effectiveness and safety for cancer survivors. J Cancer Surviv 2012; 6: 219–228.

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Gender differences in physical activity following acute myocardial infarction in adults: A prospective,observational study

Abstract

Aims

Methods and results

Conclusions

Keywords

Get full access to this article

References

Supplementary Material