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coronary heart disease, physical activity, maintenance, risk factors, community health



  1. Wang, Jianhui MSN
  2. Liu, Huaping PhD, RN, FAAN
  3. Chen, Changxiang MSN, RN
  4. Chang, Wenhong BN, RN
  5. Ma, Yi PhD, MD
  6. Zhao, Caijie MSN, RN
  7. Smith, Sidney C. Jr MD
  8. Han, Jing MSN, RN
  9. Yu, Miao BN
  10. Ma, Jiahui BN
  11. Qi, Jing BN, RN
  12. Xing, Yan MSN, RN


Background: The level of physical activity (PA) among patients with coronary heart disease (CHD) living in Chinese communities who do not participate in cardiac rehabilitation programs and the factors contributing to patient maintenance of PA are unclear.


Objective: This cross-sectional study, guided by the Transtheoretical Model, evaluated (1) the maintenance of PA in Chinese patients with CHD 12 months after hospital discharge and (2) the demographic, clinical, and psychological characteristics associated with maintenance of PA.


Methods: A total of 1162 patients completed 6 questionnaires at 12 months posthospitalization to assess their maintenance of PA, stage of change, symptoms of depression and anxiety, and health-related quality of life and sleep.


Results: Only 40% of patients with CHD maintained regular PA 12 months after hospital discharge. Walking was their primary PA. Thirty-seven percent of patients reported no intention of having regular PA. Male sex (odds ratio [OR], 1.69), awareness of PA's cardiac benefit (OR, 4.12), a history of regular PA before the cardiac event (OR, 6.08), history of chronic disease (OR, 1.43), mild depressive symptoms (OR, 1.40), moderate and severe depressive symptoms (OR, 0.41), smoking (OR, 0.54), and years of CHD (OR, 0.96) were related to maintenance of regular PA. Patients with CHD who maintained regular PA had better quality of life and sleep (P < .001) and fewer unplanned clinic visits (P = .001) and cardiac cause readmissions (P = .012) and reported fewer declines in PA capacity (P < .001).


Conclusions: Walking is the most common form of PA 12 months posthospitalization among patients with CHD in China. Patient education and counseling about the cardiac benefits of PA, taking into account stage of change, are important considerations to improve maintenance of PA.