title: Gender differences in physical activity following acute myocardial infarction in adults: A prospective, observational study.
abstract: Aims Despite the benefits of regular physical activity participation following acute myocardial infarction, little is known about gender differences in physical activity among patients after acute myocardial infarction. We described, by gender, physical activity trajectories pre- and post-acute myocardial infarction, and determined whether gender was independently associated with physical activity. Methods and results The Variation in Recovery: Role of Gender on Outcomes of Young AMI patients (VIRGO) study, conducted at 103 US, 24 Spanish, and three Australian hospitals, was designed, in part, to evaluate gender differences in lifestyle behaviors following acute myocardial infarction. We used baseline, one-month, and 12-month data collected from patients aged 18-55 years ( n = 3572). Patients were assigned to American Heart Association-defined levels of physical activity. A generalized estimating equation model was used to account for repeated measures within the same individual over time. Men were more active (≥150 min/wk moderate or ≥75 min/wk vigorous activity) than women at baseline (42% vs 34%), one month (45% vs 34%), and 12 months (48% vs 36%) (all p < 0.0001). Men engaged in a significantly longer duration of activity at each time point. When controlling for all other factors, women had 1.37 times the odds of being less active than men from pre-acute myocardial infarction to 12-months post-acute myocardial infarction (95% confidence interval: 1.21-1.55). Non-white race, non-active workplaces, smoking, diabetes, hypertension, and obesity were also associated independently with being less active over time (all p < 0.05). Conclusions Although activity increased modestly over time, women recovering from acute myocardial infarction were less likely to meet physical activity recommendations than were men. By identifying factors associated with low levels of activity during acute myocardial infarction recovery, targeted interventions can be introduced prior to hospital discharge.
authors.affiliation: 1 Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, USA.|2 Graduate School of Arts and Sciences, Yale University, USA.
authors.forename: Karl E
authors.initials: KE
authors.lastname: Minges
authors.affiliation: 1 Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, USA.
authors.forename: Kelly M
authors.initials: KM
authors.lastname: Strait
authors.affiliation: 3 Behavioural Epidemiology Laboratory, Baker IDI Heart and Diabetes Institute, Australia.
authors.forename: Neville
authors.initials: N
authors.lastname: Owen
authors.affiliation: 4 Physical Activity Laboratory, Baker IDI Heart and Diabetes Institute, Australia.|5 Centre for Exercise and Nutrition, Australian Catholic University, Australia.
authors.forename: David W
authors.initials: DW
authors.lastname: Dunstan
authors.affiliation: 6 Exercise and Health Sciences, University of Massachusetts Boston, USA.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Camhi
authors.affiliation: 7 Department of Chronic Disease Epidemiology, Yale School of Public Health, USA.
authors.forename: Judith
authors.initials: J
authors.lastname: Lichtman
authors.affiliation: 1 Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Geda
authors.affiliation: 1 Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, USA.|8 Department of Emergency Medicine, Yale University School of Medicine, USA.
authors.forename: Rachel P
authors.initials: RP
authors.lastname: Dreyer
authors.affiliation: 9 Centro Nacional de Investigaciones Cardiovasculares, Universidad Complutense de Madrid, Spain.
authors.forename: Héctor
authors.initials: H
authors.lastname: Bueno
authors.affiliation: 10 Discipline of Medicine, University of Adelaide, South Australia.
authors.forename: John F
authors.initials: JF
authors.lastname: Beltrame
authors.affiliation: 1 Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, USA.|11 Section of Cardiovascular Medicine, Yale School of Medicine, USA.
authors.forename: Jeptha P
authors.initials: JP
authors.lastname: Curtis
authors.affiliation: 1 Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, USA.|11 Section of Cardiovascular Medicine, Yale School of Medicine, USA.|12 Robert Wood Johnson Clinical Scholars Program, Yale School of Medicine, USA.|13 Department of Health Policy and Management, Yale School of Public Health, USA.
authors.forename: Harlan M
authors.initials: HM
authors.lastname: Krumholz
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia; D000072038:Cardiac Rehabilitation / Q000379:methods*; D016009:Chi-Square Distribution; D015444:Exercise; D005081:Exercise Therapy; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D016017:Odds Ratio; D010349:Patient Compliance; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013030:Spain; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult
keywords: Exercise; myocardial infarction; risk factors; women