Physical activity lowers all-cause and cardio-cerebrovascular mortality in adults with coronary heart disease

Background: The health outcomes and their adherence to guideline-based secondary prevention physical activity in US patients with coronary heart disease (CHD), together with the association between physical activity (PA) and mortality risk, were investigated. Methods: Data on CHD patients (aged 18 to 85 years) was acquired from the US National Health and Nutrition Examination Survey (NHANES) 1999 -2018. The patients were divided into four groups according to the level and frequency of PA, namely, a) sedentary ( n =1178), b) moderate PA (moderate, n = 270), c) vigorous PA once or twice per week (vigorous <= 2x, n = 206), and d) vigorous PA three or more times per week (vigorous >2x, n = 598). Logistic analysis was used to determine the relationship between PA and all-cause or cardiocerebrovascular mortality in CHD patients. Results: A total of 2252 patients with CHD were enrolled, of whom 47.69% reported adequate PA. During the investigation, there were 296 (13.14%) cardio-cerebrovascular and 724 (32.15%) all-cause deaths. The incidence of all-cause or cardio-cerebrovascular death was lowest in the vigorous <= 2x group. Patients who undertook vigorous PA <= 2x showed the lowest risk of all-cause (odds ratio 0.32; 95% confidence interval 0.22 -0.47; P < 0.01) or cardio-cerebrovascular death (odds ratio 0.43; 95% confidence interval 0.25 -0.73; P < 0.01) relative to those in the sedentary group. More frequent vigorous PA did not lead to improved benefits. Conclusions: Vigorous PA once or twice per week was more effective for reducing all-cause and cardiocerebrovascular mortality compared with patients performing no or a moderate level of PA in US adults with CHD.