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PhD Student

Course Start: March 2019

Supervisor: Dr Daniel Bailey
Supervisor 2: Dr Jo Richards

Working thesis title

Reducing sedentary behaviour as a tool for secondary prevention of cardiovascular disease.

Abstract

Seven million people in the UK are living with Cardiovascular Disease (CVD) every year (BHF, 2018). Following a cardiac event, many patients uptake Cardiac Rehabilitation to form their recovery process. Cardiac Rehabilitation is a multi-disciplinary approach aimed to improve health outcomes; incorporating exercise, diet modification, smoking cessation and other lifestyle changes. BACPR, the governing body for cardiac rehabilitation, recommends ‘The patient should receive individual guidance and advice on active daily living together with a tailored activity and exercise plan with the collective aim to increase physical fitness, as well as overall daily energy expenditure and decrease sedentary behaviour’.

Sedentary behaviour is a well-established risk factor of CVD, and thus a public health concern. It is defined as an energy expenditure of £1.5 METs (metabolic task equivalent). Studies suggest that despite meeting current physical activity guidelines, many people remain sedentary. This leads to adverse health outcomes. A systematic review analysed 18 studies (16 observational and 2 cross-sectional), consisting of 794,577 participants. Striking results exhibited an increase in relative risk of 112%, 147% and 90% in CVD, CV mortality and all-cause mortality respectively (Wilmot, et al., 2012). This is frequently replicated; a latter study also suggesting increased relative risk due to sedentary behaviour (18% CV mortality, and 91% in T2DM) (Biswas et al., 2015).

Despite recommendations to reduce sedentary behaviour from the BACPR, there is little research as to whether the effects of sedentary behaviour on established CVD are the same or exacerbated due to the nature of the disease. Previous studies that have typically measured the effects of sedentary behaviour on health outcomes have been in young individuals, without hypokinetic disease, such as CVD. Likewise, there is little in the way of interventions within these disease populations to reduce sedentary behaviours. This therefore demonstrates a current gap in the research.

Research Questions

• What is the association between cardiometabolic risk markers with cardiac function and structure?
• What is the effect of interrupting sitting time with standing or light intensity physical activity following a cardiac event?

About Me

My interest in Cardiovascular Prevention and Rehabilitation began during my third year of my undergraduate degree (Sport and Exercise Science) at the ÌìÃÀ´«Ã½ of Kent. Here, I conducted a research project that compared energy expenditure in cardiac and healthy individuals. From this, I completed an MSc in Preventive Cardiology at Imperial College, London and BACPR Level 4 Cardiac Exercise Instructor qualification. I am also a qualified Level 3 Personal Trainer.

Alongside then working in a number of phase 3 NHS led cardiac rehabilitation programmes, I worked in the role of a Cardiology Research Assistant at the Royal Berkshire NHS Foundation Trust. A large part of my role here was to help develop collaborative research projects between the hospital and the ÌìÃÀ´«Ã½ of Reading.

Since starting my PhD study at the ÌìÃÀ´«Ã½, I have also been employed by Bedford Hospital NHS Foundation Trust as a Cardiac Rehabilitation Exercise Specialist in phase 3 Cardiac Rehabilitation, which puts me in a fantastic position to develop evidence based practice within the programme. In the future, I aim to become an academic in the area of Cardiovascular Prevention and Rehabilitation, as well as to continue with its research.Ìý

Contact Information

E: Abbie.Bell@study.beds.ac.uk
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