Comparison of physical activity levels between men and women with major cardiovascular diseases
Authors: Machado F , Claes J , Cornelis N , De Wilde C , Decorte E , Goetschalckx K , Bekhuis Y , Fourneau I , Kuznetsova T , Hansen D , Cornelissen V 
Published: June 2024

Abstract

Background/Introduction
Physical activity in daily life (PADL) is a crucial factor influencing mortality and quality of life in individuals with cardiovascular diseases (CVDs). While previous research demonstrates notable differences in exercise habits and PADL levels between men and women in the general population, little is known about the patterns of PADL among men and women with CVDs.

Purpose
To compare PADL between men and women with coronary heart disease (CHD), heart failure with preserved ejection fraction (HFpEF), and peripheral artery disease (PAD).

Methods
This retrospective and cross-sectional analysis used baseline data from three exercise intervention studies. Participants were recruited between 2017 and 2023 at a University Hospital, were on optimal medical treatment and stable for at least four weeks. PADL was evaluated using validated activity monitors (ActiGraph GT9X Link or SenseWear Armband) with measurements deemed valid when participants recorded at least 3 weekdays and 1 weekend-day with a minimum of 10 hours of wear-time. Primary outcomes included the number of steps per day and the total amount of activity performed at least moderately (≥3METs) denoted as moderate-to-vigorous physical activity (MVPA). A two-way ANCOVA with Bonferroni post hoc test correction was conducted to examine the independent effects of sex and CVD diagnosis on PADL, after controlling for age, BMI and period of PADL assessment. The results are presented as mean differences, 95% confidence intervals (CI), and p-values.

Results
The analysis included 258 patients (age: 64±11 years, BMI: 28.7±4.5 kg/m²). Among them, 111 patients were diagnosed with CHD (80% men), 96 with HFpEF (51% men, 46% stage A, 30% stage B, 24% stage C) and 51 with PAD (75% men). Adjusted means and standard errors of steps and minutes of MVPA per day are presented in Figure 1. There was no statistically significant interaction between sex and CVD on steps per day (p = .181, partial η2 = .014). The main effect of CVD showed a statistically significant difference in adjusted mean steps per day which was lower for those with PAD (4,549 steps/day) versus those with CHD (12,239 steps/day), (-7,690 [95%CI, -9,785 to -5,594] steps/day, p = &lt;0.001) and those with HFpEF (12,325 steps/day), (-7,776 [95%CI, -11,228 to -4,323] steps/day, p = &lt;0.001). In contrast, there was a statistically significant interaction between sex and CVD on MVPA (p = .032, partial η2 = .027). The effect of sex in patients with PAD was not statistically significant (p = .517). The difference in adjusted mean MVPA was statistically significantly lower in men versus women with HFpEF (-22 [95%CI, -43 to -2] min/day, p = .035) and CHD (-44 [95%CI, -69 to -19] min/day, p &lt; .001).

Conclusion
Our study reveals sex-related differences in PADL among patients with CVDs. Men with CHD or HFpEF exhibit lower MVPA in their daily life compared to women, emphasizing the need for tailored interventions to improve PADL. PADL Variation: Men vs. Women in CVDs.