Physical activity in the first week after a heart attack does not lead to an increase in new heart problems in the five years afterward, according to a study by Radboudumc. Starting to move, such as walking for an hour a day, appears to be safe. In addition, people who were already physically active in the period before their heart attack actually fare better five years later than people who were very sedentary.
It is well known that physical activity is important to prevent future health problems after a heart attack. Participation in a cardiac rehabilitation program is therefore recommended, but such programs usually do not start until several weeks or even months after the infarction. Very little research has been done on physical activity during this intervening period.
In practice, people appear to move very little immediately after their heart attack. 'It is somewhat more than in the past, because people stay in hospital for a shorter time and are more active at home than during admission', says PhD candidate Rik Dijkman of Radboudumc. 'But people still find movement daunting and are afraid the pain will return. Doctors also often advise taking it easy, due to safety concerns that are not based on evidence.'
Walking
Dijkman and his team therefore investigated the effect of early movement after a heart attack on health outcomes. He followed 165 patients for up to five years after a heart attack. In the first week after discharge from the hospital, they wore a monitor on their upper leg that measured their activity. A questionnaire also assessed how physically active people were before their heart attack. Over the five years following the infarction, the researchers recorded which heart problems occurred, such as a new heart attack.
Based on the activity monitor data, the researchers divided patients into two groups. The most active group moved for almost five hours per day. This included only light activities, such as getting dressed and making coffee, but also nearly one hour per day of activity such as walking. It did not involve moderate- to high-intensity exercise or sports. The less active group moved for 2.5 hours per day, meaning they were about half as active as the more active group.
Sedentary Individuals
The active group did not experience new heart problems more often than the inactive group. This suggests that moving immediately after a heart attack is safe. The researchers focused on activities such as walking, not on sports. In addition, people who had been more physically active before their heart attack had fewer heart problems five years later than those who were more sedentary. Both findings support an active lifestyle.
'The period after a heart attack can serve as a learning moment, because patients are then more receptive to reconsidering their lifestyle behavior. It now appears safe to encourage early activity during this period', says Dick Thijssen, professor of Cardiovascular Physiology at Radboudumc. 'The longer survival without cardiac complaints among patients who were physically active before admission emphasizes the long-term protective effects and supports the promotion of an active lifestyle.'
About the publication
This research was published in the American Journal of Preventive Cardiology: Pre- and post-discharge physical activity in acute myocardial infarction: Relation to clinical events across 5-year follow-up. Rik Dijkman; Sophie H. Kroesen; Bram M.A. van Bakel; Robert Jan M. van Geuns; Aukelien C. Dimitriu-Leen; Thijs M.H. Eijsvogels; Dick H.J. Thijssen. DOI: 10.1016/j.ajpc.2026.101641.
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