Physical activity and sedentary behaviour in secondary prevention of coronary artery disease: A review

Abstract

Comprehensive management of coronary artery disease (CAD) includes physical exercise as a part of daily lifestyle therapy. Still CAD patients generally have low physical activity (PA) and high sedentary behaviour (SB). This review summarizes the effect of exercise training and habitual PA and SB on physical fitness and quality of life (QoL) as well as on rehospitalizations and mortality in patients with stable CAD, recent acute coronary syndrome (ACS) or recent revascularization. A literature review of the influence of exercise, and PA and SB profiles in secondary prevention of CAD was performed using PubMed. All articles published between January 2001 and April 2019, meeting the inclusion criteria were considered. A total of 25 cross-sectional or prospective studies or randomized controlled trials (RCT) were included to this review. Exercise training was found to improve maximal oxygen consumption, QoL, and to reduce rehospitalizations and mortality among patients with established CAD. Remote PA interventions have not been as effective as the supervised exercise sessions in reducing the clinical endpoints. High SB, especially when combined to low PA, is associated with poor cardiorespiratory fitness and worse long-term prognosis among patients with ACS. In conclusion, exercise training and high PA are beneficial for patients with stable CAD, recent ACS or recent revascularization. High SB is associated with poor cardiopulmonary fitness and increased mortality in ACS patients. Novel tools using online applications and smart devices are promising means to offer remote guidance for PA among patients unable to participate in regular exercise sessions.

Objectively measured preoperative physical activity and sedentary behaviour among Finnish patients scheduled for elective cardiac procedures: baseline results from randomized controlled trial

“…Because CVDs are a major economic burden to the health care, exercise-based interventions provide a cost-effective way of alleviating it [ 34 ]. Also, preoperative interventions for cardiac patients, with for example an accelerometer or applications, might reduce postoperative complications [ 35 – 37 ]. Therefore, both pre- and postoperative rehabilitation to increase physical activity and reduce sedentary behaviour could improve postoperative recovery.…”

Role of received social support in the physical activity of coronary heart patients: The Health Action Process Approach

“…On the one hand, the positive effects of physical activity prevail against several risk factors of CAD, including hypertension, the level of LDL and non-HDL cholesterol, body weight, and type 2 diabetes (Glazer et al, 2013;Winzer et al, 2018). On the other hand, having a sedentary lifestyle is one of the major risk factors for coronary artery disease worldwide (Lee et al, 2012), as well as for secondary prevention (Vasankari et al, 2021). Relatedly, several studies (Janssen et al, 2014;Meng et al, 2014) have consistently proved that interventions targeting physical activity in cardiac rehabilitation could be useful and efficient in the initiation and maintenance of physical activity among cardiac patients.…”

Supervised and Individualized Lifestyle Medicine Therapy of a Patient after Myocardial Infarction—Case Study

“…Although other research [ 14 ] has reported the opposite results, exercise interventions in health programs improve patients’ overall health and cardiac function [ 6 , 12 ]. There is also evidence that regular moderate exercise can reduce rehospitalizations among patients with stable coronary artery disease [ 15 ], especially if it is accompanied by smoking cessation and a Mediterranean diet [ 11 ]. These results confirm that rehabilitation of CVD patients with lifestyle medicine therapy is particularly important to improve the patient’s quality of life.…”