We hypothesized that individuals with CHD would be less physically active than the general population without CHD. Before PSM, patients with CHD spent significantly less time participating in vigorous activity, leisure, transportation, and total physical activity and significantly more time spent sedentary compared to non-CHD patients. It was observed that Considering the differences in sociodemographic and lifestyle variables between the two groups, we compared the groups using PSM. After matching, people with CHD had similar physical activity levels to people without CHD, except for work-related physical activity. Men with CHD spent significantly less time in leisure-time physical activity, whereas women reported more work-related physical activity. Among people younger than 65 years, those with CHD spent significantly more time sedentary than those without CHD.
When matched for sociodemographic and lifestyle variables, similar physical activity levels were observed in people with and without CHD. A study in the United States reported age-standardized proportions of adults with and without CHD who participated in physical activity at recommended levels. Their data showed that people with CHD reported less total physical activity (40% meeting recommendations vs. 49% meeting recommendations) and moderate physical activity (32% vs. 37%) compared to non-CHD patients. , and participation in vigorous exercise (22% vs. 29%) was significantly lower. CHD15. Another study reported physical activity participation rates (moderate or vigorous physical activity for at least 20 minutes at least once a week: 38%) in patients with coronary artery disease in European countries, compared with patients without CHD. has not been reported.16. Furthermore, a discrepancy exists between the results of the current study and those of Baker et al.17, reported a significant reduction in objectively measured physical activity compared to a health control group. One of the main differences between our study and Baker et al.’s study is the average age of the participants. In particular, participants in Baker et al. (2019) were significantly older (no disease: 61.0 ± 8.0 years for men, 60.7 ± 7.7 years for women; with chronic disease: 65.5 ± 7.1 years for men, 63.5 ± 7.5 years for women). age). Considering that vigorous physical activity tends to decrease with age, lower participation in physical activity has been observed in patients with CVD compared to non-CVD patients, which is associated with older age in patients with CVD. This may be partially due to this. In our study, we employed propensity score matching. As a result, we were able to compare levels of physical activity participation among participants matched for age, BMI, education, household income, alcohol intake, and smoking status. This approach enhances the robustness of comparisons, minimizes potential confounding effects, and allows for a more accurate assessment of the impact of chronic disease on physical activity participation.
When interpreting our data, it should be noted that physical activity levels are generally lower among Korean adults compared to other countries. A recent study on the prevalence of physical activity among Korean adults aged 60 to 69 years reported that 10.2% engaged in high levels of physical activity.18which is lower than among Czech elderly (24.9-28.3%).19 Iranians aged 55 to 64 (23.7%)20. Additionally, some CHD patients may have realized the importance of PA and tried to become more physically active. Stewart et al reported that 34% of CHD patients increased their physical activity after CHD diagnosis.twenty one Similar results have been reported in European samples16. The extent to which people are motivated to increase their activity level after diagnosis and the long-term effects are unknown and may vary by country and ethnicity.
In our subgroup analysis, we observed that men with CHD had lower participation in leisure-time physical activity, whereas women with CHD had higher levels of work-related physical activity. It is noteworthy that although there were no significant differences in the amount of work-related physical activity before matching, significant differences emerged after matching. Further investigation with subgroup analysis showed that this difference in work-related physical activity was specific to women. The reasons for increased work-related physical activity in women with CHD remain unclear, especially considering that a smaller proportion of women with CHD are employed. It is important to recognize that the GPAQ not only assesses occupational physical activity, but also encompasses physical activity associated with unpaid work, housework, and food/crop harvesting. Furthermore, it is pertinent to emphasize that the type of employment was comparable between those with and without CHD. Therefore, the differences in work-related physical activity observed in our study may be due, at least in part, to differences in socio-economic status. It is important to further investigate and understand the factors that contribute to the physical activity patterns observed among women with CHD across a variety of disciplines. Men and women younger than 65 years with CHD spent significantly more time sedentary than men and women without CHD.
It is noteworthy that, consistent with the results of previous studies, CHD patients were shown to spend significantly more time sedentary in our study.27,28.Because replacing sedentary time with physical activity may reduce inflammation29CVD mortality, and all-cause mortality30, people with CHD should be encouraged to limit the time they spend in sedentary activities. Replacing sedentary time with leisure-time physical activity should be strongly encouraged. The sociodemographic characteristics of her CHD patients who report high levels of work-related physical activity need to be further analyzed. Whether CHD patients who report high levels of work-related physical activity require additional leisure activities should be a question for future research in this area.
Less sitting time and higher levels of leisure-time physical activity are associated with beneficial effects on CVD22,30. Prolonged sedentary time negatively impacts CVD markers such as blood pressure, high-density lipoprotein, low-density lipoprotein, and C-reactive protein.31. Similar to previous studies, people with CHD spent significantly more time sedentary than people without CHD. All activities performed during the day are interdependent, so the more time you spend sitting, the less time you spend being physically active. Recent studies point to the need to incorporate more advanced measurements such as accelerometers to identify posture and differentiate sedentary patterns. Future studies should also apply isochronous displacement modeling approaches to determine the (health effects) of reducing sedentary time and increasing time spent on other areas of physical activity.
One of the limitations of our study is that the diagnosis of CHD was based on a subjective questionnaire. This method may include cases of angina unrelated to CHD, and some patients may not have experienced a myocardial infarction. Another limitation stems from the broad definition of CHD, which includes a range of severity, from angina with minimal and well-controlled symptoms to angina experiencing worsening of symptoms. . Furthermore, the measurement of physical activity in our study relied on subjective self-reported data. The CHD patients in our study may have had socially desirable responses to the physical activity questionnaire, which could lead to over-reporting of physical activity levels. Although objective/device-based methods such as accelerometers cannot distinguish between different regions of physical activity, our findings remain reliable. Future studies may include simultaneously implementing both objective and self-report methods to assess physical activity, as a more comprehensive approach. This provides a more nuanced and accurate understanding of an individual’s activity level, contributing to a more robust interpretation of the relationship between CHD and physical activity. Furthermore, although we adjusted for key factors related to demographics and lifestyle, we cannot exclude unmeasured confounding by physical activity level or other diseases or factors that may influence her CHD. . Despite these limitations, our study is the first to compare physical activity levels in people with and without CHD after closely matching sociodemographic and lifestyle variables on a national scale. is.
