Department of Biobehavioral Sciences Teachers College Columbia University New York NY.
Center for Behavioral Cardiovascular Health Columbia University Irving Medical Center New York NY.
J Am Heart Assoc. 2019 Aug 6;8(15):e011585. doi: 10.1161/JAHA.118.011585. Epub 2019 Jul 31.
Background Sedentary behavior is a key contributor to cardiovascular disease. Few data exist on the sedentary behavior patterns of patients with acute coronary syndrome. Methods and Results We characterized patterns of sedentary time and their correlates in 149 patients with acute coronary syndrome over the first month postdischarge, a critical period when lifestyle behaviors are formed. Sedentary time was measured by accelerometry for 28 days postdischarge. Group-based modeling at the day level was used to characterize sedentary patterns. Participants spent a mean of 9.7±2.0 hours per day sedentary during the 28 days postdischarge, with significant decreases in sedentary time observed in each consecutive week (P<0.01 for all). Three distinct sedentary patterns were identified: high (20.6% of participants), moderate (47.9%), and low (31.5%). The high and moderate sedentary groups spent a mean of 12.6±0.8 and 10.0±0.7 hours per day sedentary, respectively, and had only minimal decreases in their sedentary time (<3 minutes per day) over the 28 days. The low sedentary group spent a mean of 7.3±0.8 hours per day sedentary, with a rapid decrease in sedentary time (14 minutes per day) observed during the first week postdischarge followed by a relatively smaller decrease (≈5 minutes per day) that persisted until day 21 postdischarge. Non-Hispanic ethnicity, left ventricular ejection fraction <40%, lower physical health-related quality of life, and not having a partner were associated with an increased likelihood of being in the high sedentary group. Conclusions Survivors of acute coronary syndrome accrued high volumes of sedentary time during the first month postdischarge, with most showing little change over time. Interventions targeting reductions in sedentary time among survivors of acute coronary syndrome may be warranted, particularly for those with poor physical health and greater disease severity.
久坐行为是导致心血管疾病的一个主要因素。目前关于急性冠状动脉综合征患者久坐行为模式的数据很少。
我们描述了 149 例急性冠状动脉综合征患者出院后第一个月内久坐时间的模式及其相关因素，这是形成生活方式行为的关键时期。出院后 28 天内通过加速度计测量久坐时间。在天水平上使用基于群组的建模来描述久坐模式。参与者在出院后 28 天内平均每天久坐 9.7±2.0 小时，连续每周观察到久坐时间明显减少（所有 P<0.01）。确定了三种不同的久坐模式：高（20.6%的参与者）、中（47.9%）和低（31.5%）。高和中久坐组平均每天分别久坐 12.6±0.8 和 10.0±0.7 小时，并且在 28 天内其久坐时间仅略有减少（<3 分钟/天）。低久坐组平均每天久坐 7.3±0.8 小时，出院后第一周观察到久坐时间迅速减少（每天 14 分钟），随后相对较小的减少（≈5 分钟/天）持续到出院后第 21 天。非西班牙裔、左心室射血分数<40%、较低的身体健康相关生活质量以及没有伴侣与处于高久坐组的可能性增加相关。
急性冠状动脉综合征幸存者在出院后第一个月内积累了大量的久坐时间，大多数人随着时间的推移变化不大。针对急性冠状动脉综合征幸存者减少久坐时间的干预措施可能是必要的，特别是对于那些身体健康状况较差和疾病严重程度较高的患者。
