Cardiol Res

Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access

Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc

Journal website http://www.cardiologyres.org

Original Article

Volume 11, Number 2, April 2020, pages 97-105

Characterization of Sedentary Behavior in Heart Failure Patients With Arthritis

Figure 3. Accelerometer measures of average daily minutes in: (a) SED; (b) moderate; (c) vigorous activities in baseline, 3 and 6 months (sex subgroup). SED: sedentary.

Figure 4. Standardized parameter estimates for proposed theoretical model based upon SCT. *P < 0.05. ***P < 0.001. Rectangles represent observed variables, independent variable with the arrow pointing toward dependent variable. The line with two arrows represents a possible correlation between the two variables, the e1 - e11 in circle represent error terms; while the numbers adjacent to the lines are standardized direct effects between the pair of connected variables. SED-time: sedentary time; HGB: hemoglobin; Educ: education; NYHC: New York Heart Classification; Self-Eff: Self-Efficacy for HF Self-management Measure by Self-Care of Heart Failure Index; AHFKT: Atlanta heart failure knowledge test (AHFKT-V2); RSCB: 29-item Revised Heart Failure Self-Care Behavior Scale; Na24: 24-h urinary Na; BMI: body mass index.

**Table 1.** Participant Characteristics in the Whole Cohort and by Sex and BMI
Variable names	Overall	Sex	BMI
^aDietary sodium intake was measured by 24-h urinary sodium excretion. Values are mean ± SD for continuous variables and n (%) for categorical variables. SD: standard deviation; BMI: body mass index; HGB: hemoglobin; NYHC: New York Heart Classification; DM: diabetes mellitus.
Age	70 ± 12.16	70 ± 12.03	70 ± 12.33	65 ± 10.50	75 ± 12.15
Years of school	12.92 ± 2.28	13.22 ± 2.79	12.75 ± 1.92	13.24 ± 2.63	12.54 ± 1.71
Marital
Partnered	51 (50.50)	26 (70.27)	25 (39.06)	30 (54.55)	21 (45.65)
Single	50 (49.50)	11 (29.73)	39 (60.94)	25 (45.45)	25 (54.35)
Annual household income
Under $10,000	16 (17.02)	1 (2.86)	15 (25.42)	6 (11.76)	10 (23.26)
$10,000 - $74,999	60 (63.83)	26 (74.29)	34 (57.63)	34 (66.67)	26 (60.47)
Over $75,000	8 (8.51)	3 (8.57)	5 (8.47)	8 (15.69)	7 (16.28)
Refused	10 (10.64)	5 (14.29)	5 (8.47)	3 (5.88)	43 (100.00)
Employment status (0)	72 (71.29)	26 (70.27)	46 (71.88)	38 (69.09)	34 (73.91)
Exercise (self-report) (+)	66 (65.35)	24 (64.86)	42 (65.63)	33 (60.00)	33 (71.74)
Low-sodium diet (self-report) (+)	25 (24.75)	10 (27.03)	15 (23.44)	12 (21.82)	13 (28.26)
Family help (self-report) (+)	15 (14.85)	9 (24.32)	6 (9.38)	11 (20.00)	8 (18.60)
Physical examination
BMI	32.05 ± 7.18	31.50 ± 6.58	32.36 ± 7.53	37.34 ± 4.88	25.72 ± 3.25
Laboratory
HGB	12.61 ± 1.89	13.18 ± 2.13	12.29 ± 1.67	12.75 ± 1.86	12.46 ± 1.94
Fasting glucose	162.08 ± 147.24	145.41 ± 76.36	171.60 ± 175.27	171.28 ± 164.28	151.04 ± 124.68
Dietary sodium intake^a	4,108.94 ± 1,822.01	3,833.48 ± 1,508.25	4,263.89 ± 1,971.08	4,271.78 ± 1,926.99	3,909.93 ± 1,684.78
Functional measures
Ejection fraction	55.81 (11.12)	52.68 (11.92)	57.75 (10.24)	56.37 (9.64)	55.21 (12.60)
NYHC class II (mild)	58 (57.43)	20 (54.05)	38 (59.38)	34 (61.82)	24 (52.17)
NYHC class III (moderate)	43 (42.57)	17 (45.95)	26 (40.63)	21 (38.18)	22 (47.83)
Medical history
Hypertension (+)	99 (98.02)	36 (97.30)	63 (98.44)	54 (98.18)	45 (97.83)
DM type 2 (+)	41 (57.75)	15 (55.56)	26 (59.09)	26 (65.00)	15 (48.39)
DM with complications (+)	33 (45.83)	12 (44.44)	21 (46.67)	23 (56.10)	10 (32.26)

Table 1. Participant Characteristics in the Whole Cohort and by Sex and BMI

Variable names

Overall

Sex

BMI

Male

Female

BMI ≥ 30

BMI < 30

Mean ± SD or n (%)

^aDietary sodium intake was measured by 24-h urinary sodium excretion. Values are mean ± SD for continuous variables and n (%) for categorical variables. SD: standard deviation; BMI: body mass index; HGB: hemoglobin; NYHC: New York Heart Classification; DM: diabetes mellitus.

Age

70 ± 12.16

70 ± 12.03

70 ± 12.33

65 ± 10.50

75 ± 12.15

Years of school

12.92 ± 2.28

13.22 ± 2.79

12.75 ± 1.92

13.24 ± 2.63

12.54 ± 1.71

Marital

Partnered

51 (50.50)

26 (70.27)

25 (39.06)

30 (54.55)

21 (45.65)

Single

50 (49.50)

11 (29.73)

39 (60.94)

25 (45.45)

25 (54.35)

Annual household income

Under $10,000

16 (17.02)

1 (2.86)

15 (25.42)

6 (11.76)

10 (23.26)

$10,000 - $74,999

60 (63.83)

26 (74.29)

34 (57.63)

34 (66.67)

26 (60.47)

Over $75,000

8 (8.51)

3 (8.57)

5 (8.47)

8 (15.69)

7 (16.28)

Refused

10 (10.64)

5 (14.29)

5 (8.47)

3 (5.88)

43 (100.00)

Employment status (0)

72 (71.29)

26 (70.27)

46 (71.88)

38 (69.09)

34 (73.91)

Exercise (self-report) (+)

66 (65.35)

24 (64.86)

42 (65.63)

33 (60.00)

33 (71.74)

Low-sodium diet (self-report) (+)

25 (24.75)

10 (27.03)

15 (23.44)

12 (21.82)

13 (28.26)

Family help (self-report) (+)

15 (14.85)

9 (24.32)

6 (9.38)

11 (20.00)

8 (18.60)

Physical examination

BMI

32.05 ± 7.18

31.50 ± 6.58

32.36 ± 7.53

37.34 ± 4.88

25.72 ± 3.25

Laboratory

HGB

12.61 ± 1.89

13.18 ± 2.13

12.29 ± 1.67

12.75 ± 1.86

12.46 ± 1.94

Fasting glucose

162.08 ± 147.24

145.41 ± 76.36

171.60 ± 175.27

171.28 ± 164.28

151.04 ± 124.68

Dietary sodium intake^a

4,108.94 ± 1,822.01

3,833.48 ± 1,508.25

4,263.89 ± 1,971.08

4,271.78 ± 1,926.99

3,909.93 ± 1,684.78

Functional measures

Ejection fraction

55.81 (11.12)

52.68 (11.92)

57.75 (10.24)

56.37 (9.64)

55.21 (12.60)

NYHC class II (mild)

58 (57.43)

20 (54.05)

38 (59.38)

34 (61.82)

24 (52.17)

NYHC class III (moderate)

43 (42.57)

17 (45.95)

26 (40.63)

21 (38.18)

22 (47.83)

Medical history

Hypertension (+)

99 (98.02)

36 (97.30)

63 (98.44)

54 (98.18)

45 (97.83)

DM type 2 (+)

41 (57.75)

15 (55.56)

26 (59.09)

26 (65.00)

15 (48.39)

DM with complications (+)

33 (45.83)

12 (44.44)

21 (46.67)

23 (56.10)

10 (32.26)

**Table 2.** Baseline and 3, 6 Month Scores for SED-Time Values, Average Hours Worn Accelerometer, and Average Kilocalories Expended (Mean ± SD)
Sex	Baseline	3 month	6 month
SED-time: sedentary time; SD: standard deviation; BMI: body mass index.
Male
BMI ≥ 30	1,280.64 ± 113.44	16.18 ± 3.83	208.07 ± 230.13	1,255.40 ± 86.39	16.08 ± 2.77	219.76 ± 166.69	1,242.06 ± 86.47	15.32 ± 3.47	289.55 ± 270.31
BMI < 30	1,255.42 ± 120.13	15.14 ± 3.98	151.67 ± 199.57	1,248.91 ± 94.57	15.75 ± 3.42	179.31 ± 168.99	1,250.67 ± 96.53	14.97 ± 3.57	165.95 ± 186.71
Female
BMI ≥ 30	1,249.72 ± 110.98	14.99 ± 3.81	142.07 ± 105.67	1,224.04 ± 119.27	16.06 ± 3.60	204.65 ± 159.80	1,248.02 ± 104.64	15.02 ± 2.83	226.88 ± 247.51
BMI < 30	1,268.23 ± 91.81	15.81 ± 2.66	91.43 ± 69.99	1,232.89 ± 75.96	16.45 ± 2.90	111.46 ± 61.59	1,238.98 ± 144.81	16.45 ± 2.55	107.53 ± 61.72

Table 2. Baseline and 3, 6 Month Scores for SED-Time Values, Average Hours Worn Accelerometer, and Average Kilocalories Expended (Mean ± SD)

Sex

Baseline

3 month

6 month

Daily minutes sedentary

Hours worn

Kilocalories expended

Daily minutes sedentary

Hours worn

Kilocalories expended

Daily minutes sedentary

Hours worn

Kilocalories expended

SED-time: sedentary time; SD: standard deviation; BMI: body mass index.

Male

BMI ≥ 30

1,280.64 ± 113.44

16.18 ± 3.83

208.07 ± 230.13

1,255.40 ± 86.39

16.08 ± 2.77

219.76 ± 166.69

1,242.06 ± 86.47

15.32 ± 3.47

289.55 ± 270.31

BMI < 30

1,255.42 ± 120.13

15.14 ± 3.98

151.67 ± 199.57

1,248.91 ± 94.57

15.75 ± 3.42

179.31 ± 168.99

1,250.67 ± 96.53

14.97 ± 3.57

165.95 ± 186.71

Female

BMI ≥ 30

1,249.72 ± 110.98

14.99 ± 3.81

142.07 ± 105.67

1,224.04 ± 119.27

16.06 ± 3.60

204.65 ± 159.80

1,248.02 ± 104.64

15.02 ± 2.83

226.88 ± 247.51

BMI < 30

1,268.23 ± 91.81

15.81 ± 2.66

91.43 ± 69.99

1,232.89 ± 75.96

16.45 ± 2.90

111.46 ± 61.59

1,238.98 ± 144.81

16.45 ± 2.55

107.53 ± 61.72

**Table 3.** Bivariate Correlations of Sedentary Time With Potential Parameters
Variable	Pearson’s coefficient	P value
*P < 0.01, P < 0.05. BMI: body mass index; SP: systolic pressure; DP: diastolic blood pressure; BNP: B-type natriuretic peptides; NYHC: New York Heart Classification; RSCB: 29-item Revised Heart Failure Self-Care Behavior Scale; Self-Eff, Self-Efficacy for HF Self-management Measure by Self-Care of Heart Failure Index; AHFKT: Atlanta heart failure knowledge test (AHFKT-V2).
Age	0.397**	0.00
Sex	-0.06	0.58
Race/ethnicity (choice = Caucasian)	0.269*	0.01
Years of school	-0.06	0.56
Health care benefits (choice = Medicare)	0.344**	0.00
Annual household income	-0.15	0.20
Distance traveled for doctor appointments	-0.253*	0.02
Currently working outside the home?	-0.322**	0.00
Work category (choice = full-time)	-0.244*	0.02
Work category (choice = part-time)	-0.227*	0.03
Work category (choice = retired)	0.261*	0.01
Work category (choice = homemaker)	-0.02	0.85
Discharge weight (kg)	-0.09	0.38
BMI	-0.06	0.57
SP admission	0.00	1.00
DP admission	-0.18	0.09
BNP (log)	0.286**	0.01
Ejection fraction	-0.03	0.82
Hemoglobin (HGB)	-0.342**	0.00
Hematocrit (HCT)	-0.332**	0.00
White blood cell (WBC)	-0.16	0.13
Hypertension	0.10	0.36
Stool softener/laxative	0.232*	0.03
NYHC	0.12	0.25
RSCB behavior scale	-0.14	0.16
Self-Eff	-0.14	0.16
AHFKT-V2	-0.13	0.21

Table 3. Bivariate Correlations of Sedentary Time With Potential Parameters

Variable

Pearson’s coefficient

P value

**P < 0.01, *P < 0.05. BMI: body mass index; SP: systolic pressure; DP: diastolic blood pressure; BNP: B-type natriuretic peptides; NYHC: New York Heart Classification; RSCB: 29-item Revised Heart Failure Self-Care Behavior Scale; Self-Eff, Self-Efficacy for HF Self-management Measure by Self-Care of Heart Failure Index; AHFKT: Atlanta heart failure knowledge test (AHFKT-V2).

Age

0.397**

0.00

Sex

-0.06

0.58

Race/ethnicity (choice = Caucasian)

0.269*

0.01

Years of school

-0.06

0.56

Health care benefits (choice = Medicare)

0.344**

0.00

Annual household income

-0.15

0.20

Distance traveled for doctor appointments

-0.253*

0.02

Currently working outside the home?

-0.322**

0.00

Work category (choice = full-time)

-0.244*

0.02

Work category (choice = part-time)

-0.227*

0.03

Work category (choice = retired)

0.261*

0.01

Work category (choice = homemaker)

-0.02

0.85

Discharge weight (kg)

-0.09

0.38

BMI

-0.06

0.57

SP admission

0.00

1.00

DP admission

-0.18

0.09

BNP (log)

0.286**

0.01

Ejection fraction

-0.03

0.82

Hemoglobin (HGB)

-0.342**

0.00

Hematocrit (HCT)

-0.332**

0.00

White blood cell (WBC)

-0.16

0.13

Hypertension

0.10

0.36

Stool softener/laxative

0.232*

0.03

NYHC

0.12

0.25

RSCB behavior scale

-0.14

0.16

Self-Eff

-0.14

0.16

AHFKT-V2

-0.13

0.21

**Table 4.** Multiple Regression Analysis of Average Daily Minutes of SED
Variable	β	P
Multiple regression analysis with stepwise backward selection of variables; Determinants: average daily minutes of sedentary. Final model (n = 64). β: beta coefficient; BNP: B-type natriuretic peptide; SP: systolic pressure.
Medical knowledge	-0.629	0
Hemoglobin (HGB)	-0.446	0
BNP	0.559	0
SP admission	-0.326	0.005
White blood cell (WBC)	0.339	0.003
Discharge weight (kg)	0.233	0.035

Table 4. Multiple Regression Analysis of Average Daily Minutes of SED

Variable

Multiple regression analysis with stepwise backward selection of variables; Determinants: average daily minutes of sedentary. Final model (n = 64). β: beta coefficient; BNP: B-type natriuretic peptide; SP: systolic pressure.

Medical knowledge

-0.629

Hemoglobin (HGB)

-0.446

BNP

0.559

SP admission

-0.326

0.005

White blood cell (WBC)

0.339

0.003

Discharge weight (kg)

0.233

0.035