People who become physically active after heart attack more likely to live longer, shows research

Becoming more physically active after a heart attack reduces the risk of death, according to research presented today at EuroPrevent 2018, a European Society of Cardiology congress. The study, which followed more than 22,000 patients, found that those who became more physically active after a heart attack halved the risk of death within four years.

"It is well known that physically active people are less likely to have a heart attack and more likely to live longer," said lead author Dr Örjan Ekblom, associate professor, Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden. "However, we did not know the impact of exercise on people after a heart attack."

This study, which was a collaboration between the GIH and Centre for Health and Performance at Gothenburg University, Sweden, assessed the association between physical activity and survival after a heart attack. The study included 22,227 patients in Sweden who had a myocardial infarction between 2005 and 2013. Data was obtained from the RIKS-HIA registry, SEPHIA registry, and Swedish Census registry.

Levels of physical activity were reported 6-10 weeks and 12 months after the heart attack. The difference between answers was considered a change in physical activity over the year following the heart attack.

On both occasions, patients were asked how many times they had exercised for 30 minutes or longer during the previous seven days. Patients were categorized as constantly inactive, reduced activity, increased activity, or constantly active.

A total of 1,087 patients died during an average follow-up of 4.2 years. The researchers analyzed the association between the four categories of physical activity and death, after adjusting for age, sex, smoking, and clinical factors. Compared to patients who were constantly inactive, the risk of death was 37%, 51%, and 59% lower in patients in the categories of reduced activity, increased activity, or constantly active, respectively.

Dr Ekblom said: "Our study shows that patients can reduce their risk of death by becoming physically active after a heart attack. Patients who reported being physically active 6 to 10 weeks after the heart attack but became inactive afterwards seem to have a carry-over benefit. But of course, the benefits for active people are even greater if they remain physically active."

Dr Ekblom said the study provided additional evidence for healthcare professionals and policy makers to systematically promote physical activity in heart attack patients. He said: "Exercising twice or more a week should be automatically advocated for heart attack patients in the same way that they receive advice to stop smoking, improve diet, and reduce stress."

"Our study shows that this advice applies to all heart attack patients," he continued. "Exercise reduced the risk of death in patients with large and small myocardial infarctions, and for smokers and non-smokers, for example."

Dr Ekblom said the study did not investigate what type of exercise patients undertook. "More research is needed to find out if there is any type of activity that is especially beneficial after a heart attack," he noted, "Should patients do resistance exercise, aerobic training, or a combination, for example? Is walking sufficient or do patients need more vigorous exercise which makes them short of breath? Answering these questions will help us to give more specific advice."

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