JAMA: Heart attacks do not always shock patients into shape

Fewer than 5% of patients make all three recommended lifestyle changes

One in four men makes no healthy lifestyle changes after suffering a stroke, heart attack, or other major cardiac event, according to a new study in JAMA.

For the study, Koon Teo—a clinician and researcher at McMaster University in Canada—and his colleagues examined the prevalence of three health lifestyle behaviors among 7,519 patients who reported having either a stroke or coronary heart disease. The three behaviors were smoking cessation, healthy eating, and physical activity and exercise.

The researchers found that only 4.3% of participants improved their smoking, eating, and exercising habits. About 30.6% of participants made two lifestyle changes, and 47.2% adopted at least one healthy behavior. Overall, 14.3% of participants made no healthy lifestyle changes.

Of the participants:

  • 52.5% of those who had ever smoked reported that they had quit;
  • 39% reported keeping a healthy diet; and
  • 35.1% reported high levels of physical activity.

In addition, overall patterns were displaced by gender. For example:

  • Women were more likely than men to improve their lifestyle habits after a cardiac event or stroke, with 7.4% of women making all three recommended changes compared with only 2.4% of men;
  • Women were 66% more likely than men to make at least two lifestyle changes; and
  • Men were more likely than women to not make any changes, with 26.4% of men changing nothing compared with only 7.2% of women.

The researchers also determined that people in urban areas were 22% more likely than those in rural locations to make at least two lifestyle changes.

"[L]ifestyle modifications to reduce the risk of recurrent cardiovascular disease events are as essential as using proven secondary prevention medications," the researchers wrote in the study. They concluded that their findings require the "development of simple, effective, and low-cost strategies for secondary prevention that are acceptable worldwide" (Kaplan, Los Angeles Times, 4/16; Petrochko, MedPage Today, 4/16).

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