Citation: Parisotto, G.; Reis, L.F.F.; Junior, M.S.; Papathanasiou, J.; Lopes, A.J.; Ferreira, A.S. Association of Multiple Cardiovascular Risk Factors with Musculoskeletal Function in Acute Coronary Syndrome Ward Inpatients. Healthcare 2023, 11, 954. https://doi.org/10.3390/ healthcare11070954 Academic Editors: Shahnawaz Anwer, Arnold Wong and Kandasamy Gok Received: 12 January 2023 Revised: 21 March 2023 Accepted: 24 March 2023 Published: 27 March 2023 Copyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). healthcare Article Association of Multiple Cardiovascular Risk Factors with Musculoskeletal Function in Acute Coronary Syndrome Ward Inpatients Gabriel Parisotto 1 , Luis Felipe Fonseca Reis 1 , Mauricio Sant’Anna Junior 2 , Jannis Papathanasiou 3,4 , Agnaldo José Lopes 1 and Arthur Sá Ferreira 1, * 1 Postgraduate Program of Rehabilitation Sciences, Augusto Motta University Center/UNISUAM, Rio de Janeiro 21032-060, Brazil; gabriel_parizoto@yahoo.com.br (G.P.); luisfelipefreis@gmail.com (L.F.F.R.); alopes@souunisuam.com.br (A.J.L.) 2 Department of Physical Therapy, Rio de Janeiro Federal Institute, Rio de Janeiro 21710-240, Brazil; mauricio.junior@ifrj.edu.br 3 Department of Medical Imaging, Allergology & Physiotherapy, Faculty of Dental Medicine, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria; giannipap@yahoo.co.uk 4 Department of Kinesitherapy, Faculty of Public Health, Medical University of Sofia, 1431 Sofia, Bulgaria * Correspondence: arthur_sf@icloud.com; Tel.: +55-2138-829-797 (ext. 2012) Abstract: This study explored the association of multiple risk factors with musculoskeletal function in adults hospitalized for acute coronary syndrome. Sixty-nine inpatients (55 ± 6 years; 67% male) admitted to the cardiology ward within <12 h were assessed regarding stress, smoking, alcoholism, hypertension, diabetes mellitus, and obesity. The musculoskeletal function was assessed by predicted values of handgrip strength of the dominant hand (HGS-D % ) and maximal inspiratory and expiratory pressures (MIP % and MEP % , respectively). After adjustment by age and sex, drinking habits showed the strongest linear association with the total number of cardiovascular disease risk factors [standard- ized ß, p-value] (ß = 0.110, p < 0.001), followed by smoking load (ß = 0.028, p = 0.009). Associations were also observed for HGS-D % with mean blood pressure (ß = 0.019 [0.001; 0.037], p = 0.048); MIP % with mean blood pressure (ß = 0.025 [0.006; 0.043], p = 0.013); and MEP % with drinking habits (ß = 0.009 [0.002; 0.016], p = 0.013) and body mass index (ß = 0.008 [0.000; 0.015], p = 0.035). Peripheral and respiratory muscle strength must be interpreted in the context of its association with cardiovascular disease risk factors in adults hospitalized for acute coronary syndrome. Keywords: coronary care units; muscle strength; rehabilitation; risk factors 1. Introduction Cardiovascular diseases (CVD) are a major burden for public health worldwide despite a decreasing trend in prevalence over the last three decades [1]. The majority of deaths from CVD are associated with multiple, either modifiable (e.g., health behaviors and some co- morbidities) or non-modifiable (e.g., age, sex, and genetics) risk factors [2]. Modifiable risk factors constitute the main therapeutic targets for intervention and rehabilitation programs via the management of health behaviors, including controlling weight, reducing stress, stopping smoking and drinking habits, and promoting physical activity [2]. Controlling comorbidities such as hypertension, diabetes mellitus, and obesity is also advocated to increase both the expectation and quality of life in this population [2]. Recent data suggest the Brazilian population follows the global trend, with a reduction in the risk of death from CVD compared to the 1990s [3]. However, with the recent flattening of the rate of decline in CVD mortality in Brazil, the research on CVD risk factors and their functional repercussion gains additional momentum [4]. Despite the promising reduction in the overall burden of CVD, ischemic heart disease ranks as the 2nd leading cause of disability-adjusted life-years after a 17% increase from Healthcare 2023, 11, 954. https://doi.org/10.3390/healthcare11070954 https://www.mdpi.com/journal/healthcare