Heart attack survivors beat smoking, but lose the battle of the bulge
Heart attack survivors who give up smoking and fatty foods remain at risk because they are failing to lose weight and take up regular exercise according to Dr Yenna Salamonson from the University of Western Sydney's School of Nursing, Family and Community Health.
Dr Salamonson surveyed 145 first-time heart attack patients from south-west Sydney about their smoking, weight, diet and exercise habits soon after their heart attack and again six months later.
"The study demonstrates that even a brush with death is often not enough to make patients commit to the comprehensive behaviour change they need," says Dr Salamonson.
"After six months, 90 percent are non-smokers (up from 71 percent at baseline), 88 percent take their prescribed medication, and 72 percent have a low-fat diet (up from 23 percent).
"But when it comes to physical activity, the majority aren't getting the exercise their hearts need - with only 41 percent exercising the recommended five times a week (up from 27 percent at baseline).
"It's a similar story with weight, with only 37 percent achieving the recommended Body Mass Index of between 18.5 and 24.9 kilograms per square metre (up from 32 percent)."
Dr Salamonson says the results show that some lifestyle changes are very hard, even for people with life-threatening illness.
"It's not much of a stretch for a patient to take their medication, but it's a lot harder to be motivated enough to participate in moderate to vigorous exercise five times a week," she says.
Also revealing were results showing the patients' weight, smoking, diet and exercise habits before their heart attack weren't much worse than those of the general population.
"29 percent of the heart attack patients were smokers, 68 percent were overweight, 88 percent didn't do enough exercise, and 73 percent had a high-fat diet," says Dr Salamonson.
"Most Australians fit that profile in at least one, if not more, ways - debunking the myth that heart attack patients are 'naughty' people who are grossly unhealthy compared to the rest of us."
Dr Salamonson says the study also demonstrates the benefits of cardiac rehabilitation programs.
"86 percent of attendees say they've had a significant change in their lifestyle at the follow-up, compared to 56 percent of heart attack patients not in a care program. 57 percent also say they feel healthier, compared to 36 percent for non-attendees," says Dr Salamonson.
"Cardiac rehabilitation was the only consistent influence on a patient's behaviour, with those who attended 12 times more likely to quit smoking and four times more likely to have a low dietary fat intake.
"Surprisingly, socio-demographic and psycho-social factors such as age, gender, marital status, education, mental outlook and stress levels failed to be a significant predictor of a patient's behaviour."
Dr Salamonson says the findings are significant for health professionals.
"Either the message about a healthier lifestyle is not getting through to heart attack survivors or they need more support from cardiac rehabilitation personnel to reach the recommended weight and exercise targets set by the National Heart Foundation of Australia and the American Heart Association," she says.
"It may also be that we need to re-think these goals. Studies show that a weight loss of only 5-10 percent is needed for significant health gains, which is more achievable than the current recommended BMI.
"Heart attack survivors are six to eight times more likely to experience a recurring cardiac event, so we need to do everything we can to encourage secondary prevention. By the same token, we need to ensure we are not setting patients up to fail."
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