Dirk De Bacquer1, Felicity Astin2, Kornelia Kotseva3,4, Nana Pogosova5, Delphine De Smedt1, Guy De Backer1, Lars Rydén6, David Wood3,7, Catriona Jennings3,4. 1. Department of Public Health and Primary Care, Ghent University, C. Heymanslaan 10-6K3, entrance 42, B-9000 Ghent, Belgium. 2. Centre for Applied Research in Health, University of Huddersfield and Calderdale & Huddersfield NHS Foundation Trust, Huddersfield, UK. 3. National Institute for Prevention and Cardiovascular Health, National University of Ireland, Galway, Ireland. 4. Imperial College Healthcare NHS Trust, London, UK. 5. National Medical Research Centre of Cardiology, Ministry of Healthcare of the Russian Federation, Moscow, Russia. 6. Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden. 7. National Heart and Lung Institute, Imperial College London, London, UK.
Abstract
AIMS: Despite the high use of cardioprotective medications, the risk factor control in patients with coronary heart disease (CHD) is still inadequate. Guidelines identify healthy lifestyles as equally important in secondary prevention as pharmacotherapy. Here, we describe reasons for poor lifestyle adherence from the patient's perspective. METHODS AND RESULTS: In the EUROASPIRE IV and V surveys, 16 259 CHD patients were examined and interviewed during a study visit ≥6 months after hospital discharge. Data gathering was fully standardized. The Brief Illness Perception questionnaire was completed by a subsample of 2379 patients. Half of those who were smoking prior to hospital admission, were still smoking; 37% of current smokers had not attempted to quit and 51% was not considering to do so. The prevalence of obesity was 38%. Half of obese patients tried to lose weight in the past month and 61% considered weight loss in the following month. In relation to physical activity, 40% was on target with half of patients trying to do more everyday activities. Less than half had the intention to engage in planned exercise. Only 29% of all patients was at goal for all three lifestyle factors. The number of adverse lifestyles was strongly related to the way patients perceive their illness as threatening. Lifestyle modifications were more successful in those having participated in a cardiac rehabilitation and prevention programme. Patients indicated lack of self-confidence as the main barrier to change their unhealthy behaviour. CONCLUSION: Modern secondary prevention programmes should target behavioural change in all patients with adverse lifestyles. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Despite the high use of cardioprotective medications, the risk factor control in patients with coronary heart disease (CHD) is still inadequate. Guidelines identify healthy lifestyles as equally important in secondary prevention as pharmacotherapy. Here, we describe reasons for poor lifestyle adherence from the patient's perspective. METHODS AND RESULTS: In the EUROASPIRE IV and V surveys, 16 259 CHD patients were examined and interviewed during a study visit ≥6 months after hospital discharge. Data gathering was fully standardized. The Brief Illness Perception questionnaire was completed by a subsample of 2379 patients. Half of those who were smoking prior to hospital admission, were still smoking; 37% of current smokers had not attempted to quit and 51% was not considering to do so. The prevalence of obesity was 38%. Half of obese patients tried to lose weight in the past month and 61% considered weight loss in the following month. In relation to physical activity, 40% was on target with half of patients trying to do more everyday activities. Less than half had the intention to engage in planned exercise. Only 29% of all patients was at goal for all three lifestyle factors. The number of adverse lifestyles was strongly related to the way patients perceive their illness as threatening. Lifestyle modifications were more successful in those having participated in a cardiac rehabilitation and prevention programme. Patients indicated lack of self-confidence as the main barrier to change their unhealthy behaviour. CONCLUSION: Modern secondary prevention programmes should target behavioural change in all patients with adverse lifestyles. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Vivencio Barrios; Carlos Escobar; Carmen Suarez; Xavier Garcia-Moll; Francisco Lozano Journal: J Clin Med Date: 2022-06-20 Impact factor: 4.964