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Few heart attack survivors get recommended physical activity

March 01, 2017

NEW YORK, NY (Mar. 1, 2017) -- Only 16 percent of heart attack survivors get the recommended amount of physical activity in the weeks after hospitalization, according to a study by researchers at Columbia University Medical Center (CUMC) and NewYork-Presbyterian.

The study was published online earlier this week in the Journal of the American College of Cardiology.

Exercise has been proven to lower the risk of having another heart attack in patients with acute coronary syndrome (ACS), which includes heart attack and unstable angina (chest pain). Current guidelines strongly recommend that ACS patients get at least 30 minutes of moderate aerobic activity, such as brisk walking, at least five days per week in the first two weeks after hospital discharge. Previous studies, which relied on self-reporting, have been unable to provide a reliable estimate of how many patients achieve this goal.

In this study, the researchers measured the amount and intensity of physical activity with a wearable activity monitor in 620 heart attack survivors. Participants were instructed to wear the device for 10 hours, or more, at least three days per week during the first month after hospitalization.

"In prior decades, heart attack survivors were counseled to remain in bed for many weeks," said Ian M. Kronish, MD, MPH, Florence Irving Assistant Professor of Medicine at CUMC, assistant professor of medicine in Columbia's Center for Behavioral Cardiovascular Health, cardiologist at NewYork-Presbyterian/Columbia and lead author of the paper. "Despite current evidence to the contrary, many ACS patients fear that straining their heart through exertion will cause chest pain or another heart attack."

Clinician-supervised exercise programs for heart attack survivors have been shown to counteract patients' fears and encourage more physical activity. However, participation in these programs remains poor. "Researchers and clinicians need to find ways of getting more people to participate in such supervised exercise programs," Dr. Kronish said.

"Nowadays, there are several consumer products that can be used to track physical activity at home. Perhaps the future holds ways to remotely monitor patients and to provide positive feedback and counseling outside of a hospital setting."
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The paper is titled, "Objectively Measured Adherence to Physical Activity Guidelines after Acute Coronary Syndrome."

Additional authors included Keith M. Diaz (Columbia University Medical Center, New York, NY), Jeff Goldsmith (Columbia University Mailman School of Public Health), Nathalie Moise (CUMC), and Joseph E. Schwartz (Stony Brook University School of Medicine, Stony Brook, NY).

This work was supported by the National Heart, Lung, and Blood Institute (grants P01 HL088117 and R01 HL098037) and the National Institutes of Health (grants K23 HL098359 and UL1 TR000040).

The authors declare no conflicts of interest.

Columbia University Medical Center provides international leadership in basic, preclinical, and clinical research; medical and health sciences education; and patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Columbia University Medical Center is home to the largest medical research enterprise in New York City and State and one of the largest faculty medical practices in the Northeast. The campus that Columbia University Medical Center shares with its hospital partner, NewYork-Presbyterian, is now called the Columbia University Irving Medical Center. For more information, visit cumc.columbia.edu or columbiadoctors.org.

NewYork-Presbyterian

NewYork-Presbyterian is one of the nation's most comprehensive healthcare delivery networks, focused on providing innovative and compassionate care to patients in the New York metropolitan area and throughout the globe. In collaboration with two renowned medical school partners, Weill Cornell Medicine and Columbia University College of Physicians & Surgeons, NewYork-Presbyterian is consistently recognized as a leader in medical education, groundbreaking research and clinical innovation.

NewYork-Presbyterian has four major divisions: NewYork-Presbyterian Hospital is ranked #1 in the New York metropolitan area by U.S. News and World Report and repeatedly named to the magazine's Honor Roll of best hospitals in the nation; NewYork-Presbyterian Regional Hospital Network is comprised of leading hospitals in and around New York and delivers high-quality care to patients throughout the region; NewYork-Presbyterian Physician Services connects medical experts with patients in their communities; and NewYork-Presbyterian Community and Population Health features the hospital's ambulatory care network sites and operations, community care initiatives and healthcare quality programs, including NewYork Quality Care, established by NewYork-Presbyterian, Weill Cornell and Columbia.

NewYork-Presbyterian is one of the largest healthcare providers in the U.S. Each year, nearly 40,000 NewYork-Presbyterian professionals deliver exceptional care for more than 4 million patient visits.

For more information, visit http://www.nyp.org and find us on Facebook, Twitter and YouTube.

Columbia University Medical Center

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