Background: Despite the proven role of exercise in the secondary prevention of cardiovascular disease, exercise participation and adherence rates are low. Many studies have documented pervasive inactivity and the correlates of this inactivity. However, few studies have examined the correlates of exercise maintenance or irregular exercise participation, particularly in a broad cardiac population.

Objective: To longitudinally examine exercise behavior patterns (ie, maintainers, irregular, and inactive) in cardiac patients, and investigate the sociodemographic (eg, age, sex, income, education level), clinical (eg, obesity, arthritis, functional status, previous exercise behavior), psychosocial (eg, anxiety, depression, illness perceptions), and environmental (ie, season) correlates of exercise patterns.

Methods: Six hundred sixty-one cardiac in-patients from 3 hospitals consented to participate (75% response rate) and were reassessed 9 and 18 (N = 465; 81% retention) months postdischarge. Exercise behavior was assessed via the Health-Promoting Lifestyle Profile II subscale using a median split.

Results: Of 417 participants (n = 96, 23% female; mean age 63.1 +/- 10.2) with complete data, 176 (42.2%) were classified as Exercise Maintainers, 89 (21.3%) as Irregular Exercisers, and 109 (26.1%) as Inactive. Multinomial logistic regression (P < .001) revealed that Exercise Maintainers were more likely to be male (OR = 4.51), have exercised prior to their diagnosis (OR = 3.24), attend cardiac rehabilitation (OR = 7.8), perceive fewer exercise barriers (OR = 0.18), and were less likely to be current smokers (OR = 0.23), past smokers (OR = 0.31), or attribute the cause of their disease to their own behavior (OR = 0.53).

Conclusions: Up to 1 in 5 cardiac patients are having difficulty maintaining regular exercise. Patients more likely to maintain exercise have positive perceptions and utilize cardiac rehabilitation.