Association of Sex and Race With Leisure Physical Activity Among Adults After Myocardial Infarction

BACKGROUND: Little is known about leisure physical activity (PA) behavior among people with previous myocardial infarction. This cross-sectional study within a cohort compared leisure PA behavior between women and men ≤61-year post myocardial infarction, overall and by race. We also examined factors that explain low leisure PA by sex-race category. METHODS: We used data of participants from the second and third waves of the Myocardial Infarction and Mental Stress Study. Least squares means of the Baecke Habitual Physical Activity Questionnaire (leisure component) were estimated for 4 sex-race categories (Black Women, non-Black women, Black men, and non-Black men) using linear mixed-effects models. The final model adjusted for education, income, obesity status, stress, depression, heart failure, and cardiac rehabilitation. Relative importance analysis identified key correlates of low leisure PA for each sex-race group. Sensitivity analyses were conducted to enhance validity and robustness. RESULTS: Participants (N = 619) had a mean age of 51 (SD: 7) years; 46% were female, and 59% were Black. Leisure PA was low among all participants, with Black women reporting the least PA overall and across all types (ie, walking, cycling, sports, gardening) compared with the other 3 groups. Correlates of low leisure PA differed by sex/race: depression (Black women), education (Black men, non-Black women), and body mass index (non-Black men). CONCLUSIONS: Personalized PA interventions addressing these factors could be effective in clinical settings. At the policy level, infrastructure improvements are needed to expand PA opportunities.