Replacing Sedentary Activity With Sleep, Exercise Beneficial in Acute Coronary Syndrome
TUESDAY, May 27, 2025 -- For patients evaluated for acute coronary syndrome, replacing sedentary behavior with sleep, light-intensity physical activity, or moderate- to vigorous-intensity physical activity is associated with a lower risk for one-year cardiac events/mortality, according to a study published online May 19 in Circulation: Cardiovascular Quality and Outcomes.
Keith M. Diaz, Ph.D., from the Columbia University Medical Center in New York City, and colleagues examined the association between sedentary behavior and one-year cardiac events/mortality among participants presenting to the emergency department of a New York City hospital with acute coronary syndrome symptoms. For 30 days postdischarge, sedentary behavior, light-intensity physical activity, moderate-to-vigorous physical activity, and sleep were measured. At one-year postdischarge, cardiac events and all-cause mortality were ascertained.
The researchers found that 8.2 percent of 609 participants experienced a cardiac event or died within one year. There was an association seen for sedentary time with an increased risk for cardiac events/mortality (tertile 2 [of three tertiles, with tertile 1 representing the lowest sedentary time and tertile 3 the highest]: hazard ratio, 0.95 [95 percent confidence interval, 0.37 to 2.40]; tertile 3: hazard ratio, 2.58 [95 percent confidence interval, 1.11 to 6.03]). Replacing 30 minutes of sedentary time with sleep, light-intensity physical activity, or moderate-to-vigorous physical activity was associated with lower cardiac event/mortality risk in isotemporal substitution analyses (hazard ratios [95 percent confidence intervals], 0.86 [0.78 to 0.95], 0.49 [0.32 to 0.75], and 0.39 [0.16 to 0.96], respectively).
“We were surprised that replacing sedentary time with sleep also lowered risk. Sleep is a restorative behavior that helps the body and mind recover, which is especially important after a serious health event like a heart attack,” Diaz said in a press release. “Our study indicates that one doesn’t have to start running marathons after a cardiovascular event to see benefits. Sitting less and moving or sleeping a little more can make a real difference. More physical activity and more sleep are healthier than sitting, so we hope these findings support health professionals to move toward a more holistic, flexible and individualized approach for physical activity in patients after a heart attack or chest pain.”
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