title: Physical activity in patients with stable coronary heart disease: an international perspective.
abstract: OBJECTIVE
  Despite the known benefits of regular exercise, the reasons why many coronary heart disease (CHD) patients engage in little physical activity are not well understood. This study identifies factors associated with low activity levels in individuals with chronic CHD participating in the STABILITY study, a global clinical outcomes trial evaluating the lipoprotein phospholipaseA2 inhibitor darapladib.
  
  
  RESULTS
  Prior to randomization, 15 486 (97.8%) participants from 39 countries completed a lifestyle questionnaire. Total physical activity was estimated from individual subject self-reports of hours spend each week on mild, moderate, and vigorous exercise, corresponding approximately to 2, 4, and 8 METS, respectively. Multivariate logistic regression evaluated clinical and demographic variables for the lowest compared with higher overall exercise levels, and for individuals who decreased rather than maintained or increased activity since diagnosis of CHD. The least active 5280 subjects (34%) reported exercise of ≤ 24 MET.h/week. A total of 7191 subjects (46%) reported less exercise compared with before diagnosis of CHD. The majority of participants were either 'not limited' or 'limited a little' walking 100 m (84%), climbing one flight of stairs (82%), or walking 1 km/1/2; mile (68%), and <10% were limited 'a lot' by dyspnoea or angina. Variables independently associated with both low physical activity and decreasing exercise after diagnosis of CHD included more co-morbid conditions, poorer general health, fewer years of education, race, and country (P < 0.001 for all).
  
  
  CONCLUSIONS
  In this international study, low physical activity was only partly explained by cardiovascular symptoms. Potentially modifiable societal and health system factors are important determinants of physical inactivity in patients with chronic CHD.
authors.affiliation: Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand.
authors.forename: Ralph
authors.initials: R
authors.lastname: Stewart
authors.forename: Claes
authors.initials: C
authors.lastname: Held
authors.forename: Rebekkah
authors.initials: R
authors.lastname: Brown
authors.forename: Ola
authors.initials: O
authors.lastname: Vedin
authors.forename: Emil
authors.initials: E
authors.lastname: Hagstrom
authors.forename: Eva
authors.initials: E
authors.lastname: Lonn
authors.forename: Paul
authors.initials: P
authors.lastname: Armstrong
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Granger
authors.forename: Judith
authors.initials: J
authors.lastname: Hochman
authors.forename: Richard
authors.initials: R
authors.lastname: Davies
authors.forename: Joseph
authors.initials: J
authors.lastname: Soffer
authors.forename: Lars
authors.initials: L
authors.lastname: Wallentin
authors.forename: Harvey
authors.initials: H
authors.lastname: White
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D001547:Benzaldehydes / Q000627:therapeutic use; D003327:Coronary Disease / Q000188:drug therapy / Q000523:psychology*; D015444:Exercise / Q000502:physiology / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D015337:Multicenter Studies as Topic; D010091:Oximes / Q000627:therapeutic use; D064801:Phospholipase A2 Inhibitors / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D057185:Sedentary Behavior; D012737:Sex Factors; D001713:Biphenyl Compounds; D004048:Diethylamines; D011744:Pyrimidinones; D013440:Sulfides
chemical_list: D001547:Benzaldehydes; D010091:Oximes; D064801:Phospholipase A2 Inhibitors; C529040:darapladib; D001713:Biphenyl Compounds; D004048:Diethylamines; D011744:Pyrimidinones; D013440:Sulfides
keywords: Cardiac rehabilitation; Coronary artery disease; Exercise; Physical activity