Only 16 percent of heart attack survivors get the recommended amount of physical activity in the weeks after hospitalization, according to a study by researchers at Columbia University Medical Center (CUMC) and NewYork–Presbyterian.

The study was published in the Journal of the American College of Cardiology.

Exercise has been proven to lower the risk of having another heart attack in patients with acute coronary syndrome (ACS), which includes heart attack and unstable angina. Current guidelines strongly recommend that ACS patients get at least 30 minutes of moderate aerobic activity, such as brisk walking, at least five days per week in the first two weeks after hospital discharge. Previous studies, which relied on self–reporting, have been unable to provide a reliable estimate of how many patients achieve this goal.

In this study, the researchers measured the amount and intensity of physical activity with a wearable activity monitor in 620 heart attack survivors. Participants were instructed to wear the device for 10 hours, or more, at least three days per week during the first month after hospitalization.

“In prior decades, heart attack survivors were counseled to remain in bed for many weeks,” said Ian M. Kronish, MD, MPH, Florence Irving Assistant Professor of Medicine at Columbia, assistant professor of medicine in Columbia’s Center for Behavioral Cardiovascular Health, cardiologist at NewYork–Presbyterian/Columbia, and lead author of the paper. “Despite current evidence to the contrary, many ACS patients fear that straining their heart through exertion will cause chest pain or another heart attack.”

Clinician–supervised exercise programs for heart attack survivors have been shown to counteract patients’ fears and encourage more physical activity. However, participation in these programs remains poor. “Researchers and clinicians need to find ways of getting more people to participate in such supervised exercise programs,” Dr. Kronish said.

“Nowadays, there are several consumer products that can be used to track physical activity at home. Perhaps the future holds ways to remotely monitor patients and to provide positive feedback and counseling outside of a hospital setting.”

The paper is titled “Objectively Measured Adherence to Physical Activity Guidelines after Acute Coronary Syndrome.”