Research shows that heart disease patients who smoke are 63% less likely to be physically active, while those eating healthy diets are 84% more likely to exercise regularly. A Gram Research analysis of 1,484 Swedish heart patients found that lifestyle factors like smoking and diet predict activity levels far better than financial circumstances or education. People with multiple health conditions alongside heart disease were also significantly less active, suggesting that managing overall health may be key to staying physically active.
A new study of nearly 1,500 Swedish adults with heart disease found that certain factors strongly predict who stays active and who doesn’t. Researchers used special motion-tracking devices to measure real physical activity over a week, then compared it to health habits and personal characteristics. The biggest surprise? Smoking, extra health problems, and being female were linked to lower activity levels, while eating a healthy diet was connected to staying more active. According to Gram Research analysis, these findings could help doctors identify heart patients who need extra encouragement to exercise.
Key Statistics
A 2026 cross-sectional study of 1,484 Swedish adults with heart disease found that regular or occasional smokers had 63% lower odds of being highly physically active compared to non-smokers.
According to research reviewed by Gram, people with heart disease who ate a healthy diet were 84% more likely to be in the high physical activity group than those with poor diets.
A study of 1,484 heart disease patients aged 50-64 found that having multiple health conditions reduced the odds of high physical activity by 55% compared to having no additional health problems.
Research showed that financial strain and education level had no significant association with physical activity in 1,484 Swedish adults with cardiovascular disease, challenging assumptions about socioeconomic barriers to exercise.
The Quick Take
- What they studied: Which personal characteristics and health habits predict how much physical activity heart disease patients actually do in their daily lives
- Who participated: 1,484 Swedish adults aged 50-64 with heart conditions like heart attacks, angina, atrial fibrillation, heart failure, or stroke. About one-third were women.
- Key finding: Smokers were 63% less likely to be physically active, people with multiple health problems were 55% less likely to be active, and those eating healthy diets were 84% more likely to be active compared to those with poor diets
- What it means for you: If you have heart disease, your doctor might use these patterns to identify whether you need extra support staying active. However, this study shows patterns, not proof that changing one factor will increase activity.
The Research Details
Researchers recruited 1,484 Swedish adults with confirmed heart disease diagnoses and asked them to wear special motion-tracking devices (accelerometers) on their hips for seven consecutive days. These devices measured exactly how much moderate-to-vigorous activity each person did, removing guesswork from activity tracking. At the same time, participants completed detailed questionnaires about their lifestyle, diet, smoking, finances, and education. The researchers also accessed medical records to identify any additional health conditions.
They then used statistical analysis to find patterns—which factors were most strongly connected to higher or lower activity levels. The study captured real-world activity rather than relying on people’s memories or estimates, which makes the measurements much more reliable. All participants had diagnosed heart conditions, so the findings apply specifically to people living with heart disease rather than the general population.
Previous research on heart disease patients relied on people remembering their activity or self-reporting, which is often inaccurate. This study used objective motion sensors, making the activity measurements trustworthy. Understanding which patients are most likely to be inactive helps doctors target interventions to those who need them most. The findings suggest that lifestyle factors (like smoking and diet) matter more than financial circumstances in predicting activity levels.
This study used a large, representative sample from Sweden with confirmed diagnoses from medical records, not just patient reports. The accelerometer measurements are objective and reliable. However, because it’s a cross-sectional study (a snapshot in time), it shows associations but cannot prove that one factor causes another. The study was conducted in Sweden, so results may differ slightly in other countries with different healthcare systems or populations.
What the Results Show
The study identified several strong predictors of physical activity levels in heart disease patients. Smoking was the most dramatic factor: people who smoked regularly or occasionally had 63% lower odds of being in the high-activity group compared to non-smokers. Having multiple health conditions beyond their heart disease also significantly reduced activity—people with two or more comorbidities had 55% lower odds of being highly active.
Age and sex also mattered. The oldest participants (those in their early 60s) were 41% less likely to be highly active than younger participants in the study. Women were 27% less likely to be in the high-activity group than men. Surprisingly, financial strain and education level showed no meaningful connection to activity levels, suggesting that money and schooling don’t determine whether heart patients exercise.
The most positive finding was about diet: people eating a healthy diet were 84% more likely to be in the high-activity group. This suggests that healthy eating and physical activity often go together as part of an overall healthy lifestyle. Alcohol consumption also showed no significant association with activity levels.
The study found that financial strain—whether people reported struggling to pay bills—had no connection to physical activity levels. This is important because it suggests that cost barriers may not be the primary reason some heart patients don’t exercise. Similarly, education level didn’t predict activity, meaning that more schooling didn’t automatically lead to more exercise. These findings challenge common assumptions about what prevents people from being active.
Earlier research on heart disease patients often relied on self-reported activity, which tends to overestimate how much people actually move. This study’s use of accelerometers provides more accurate data. Previous studies suggested that socioeconomic factors (money and education) were major barriers to exercise, but this research found those factors less important than lifestyle choices like smoking and diet. The strong connection between healthy eating and activity aligns with other research showing that healthy behaviors cluster together.
This study shows associations but cannot prove cause-and-effect relationships. For example, it shows that smokers are less active, but doesn’t prove that smoking causes inactivity—it’s possible that less active people are more likely to smoke. The study included only Swedish adults aged 50-64, so findings may not apply to younger or older heart patients or different populations. The study is a snapshot in time, so it doesn’t show whether these patterns stay consistent over months or years. Finally, the study didn’t measure why people make certain choices, only what choices they made.
The Bottom Line
If you have heart disease, focus on quitting smoking and eating a healthy diet—these show the strongest connections to staying active. Discuss your activity level with your doctor, especially if you have multiple health conditions, as you may benefit from a personalized exercise plan. These findings suggest lifestyle changes may be more impactful than financial circumstances. Confidence level: Moderate—this shows strong patterns but doesn’t prove causation.
Heart disease patients aged 50-64 should pay attention to these findings, as they directly apply to this age group. Doctors treating heart disease patients can use these patterns to identify who might need extra support. People with multiple health conditions alongside heart disease should be especially attentive to activity levels. The findings are less certain for younger or older patients or those in different countries.
Changes in physical activity can improve heart health within weeks to months, but the strongest benefits typically appear after 3-6 months of consistent activity. Quitting smoking shows benefits even faster—heart function can improve within days to weeks.
Frequently Asked Questions
What factors predict if someone with heart disease will exercise regularly?
Smoking status and diet are the strongest predictors. Smokers are 63% less likely to be active, while people eating healthy diets are 84% more likely to exercise. Having multiple health conditions also reduces activity levels significantly.
Does money affect how much heart patients exercise?
No, this study found financial strain had no meaningful connection to physical activity levels in heart disease patients. Lifestyle choices like smoking and diet mattered far more than financial circumstances.
Are women with heart disease less active than men?
Yes, women were 27% less likely to be in the high-activity group than men. Age also matters—older participants in the study were 41% less likely to be highly active than younger ones.
How can heart patients increase their physical activity?
Focus on quitting smoking and improving diet quality, as these show the strongest connections to staying active. Discuss your specific situation with your doctor, especially if you have multiple health conditions, for a personalized activity plan.
Does education level affect exercise in heart disease patients?
No, education level showed no significant association with physical activity. This suggests that knowledge alone doesn’t determine exercise habits—behavioral and lifestyle factors matter more.
Want to Apply This Research?
- Log daily moderate-to-vigorous activity minutes (like brisk walking, cycling, or swimming) and track weekly totals. Set a goal of 150 minutes per week, which is standard for heart disease patients, and monitor progress weekly.
- If you smoke, use the app to track smoke-free days and connect with smoking cessation resources. If diet needs improvement, log meals and compare them to a healthy eating pattern. Use the app to set reminders for daily activity and celebrate weekly milestones.
- Track activity, diet quality, and smoking status weekly. Review monthly trends to identify patterns. Share data with your doctor quarterly to adjust your heart disease management plan based on real activity levels rather than estimates.
This research shows associations between factors and physical activity in heart disease patients but does not prove cause-and-effect relationships. These findings apply specifically to Swedish adults aged 50-64 with diagnosed heart conditions and may not apply to other age groups or populations. Always consult with your cardiologist or healthcare provider before starting or changing an exercise program, especially if you have heart disease or multiple health conditions. This article is for educational purposes and should not replace professional medical advice.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.