‘Disappointing’ survey finds many cardiac patients carry on with unhealthy lifestyle

Many Maltese patients who undergo emergency cardiac surgery and similar interventions are failing to adhered to lifestyle changes such as kicking the smoking habit, eating better, and taking up exercise.

Despite the documented evidence of the benefits of lifestyle “cardio-protective” behaviour, in reducing recurrent atherosclerotic coronary events, many Maltese patients still fail to adhere to the proposed lifestyle therapies.

Cardiology-registered nurse Justin Lee Mifsud, who presented the conclusions of the ‘Patient Adherence to Cardio-protective lifestyle Interventions’ (PACI) study at London’s St Mary’s Hospital, described the findings as ‘disappointing’.

“The average rate of Maltese patients who underwent emergency coronary artery stenting and took up a cardio-protective lifestyle adherence, namely by not smoking, performing aerobic physical activities, consuming five fruits and vegetables per day, consuming three portions of oily fish per week and eating a healthy diet amounted to only 52.5%,” Mifsud said.

The PACI survey was carried out in 2012-2013 at Mater Dei Hospital. Consecutive patients with a clinical diagnosis of coronary heart disease who had an emergency stent, were identified retrospectively from 2007-2012 and subsequently interviewed.

At interview, 31.6% of respondents continued to smoke following their cardiac intervention, while 36.3% consumed the recommended portions of fruits and vegetables per day, 9.8% consumed the three portions of oily fish per week and just 30.6% were taking up moderate levels of aerobic physical activities as per guidelines.

But why is there such a poor adherence to good advice by people who have undergone serious cardiac interventions?

“There are consistent factors which have been found to be associated with non-adherence,” Mifsud said. “They include negative stress, obesity, diabetes, advanced age, poor health, lack of enjoyment from physical activities and low expectations from physical activity benefits.

“This study shows that a large proportion of Maltese patients with prevalent coronary heart disease do not adopt the lifestyle or take into account the risk factor targets for secondary prevention. Moreover, despite remarkable pharmacological and technological advances in cardiology in recent years, recurrent cardiovascular events will still remain a major cause of death amongst individuals with established coronary heart disease.”

Mifsud said that there is still considerable potential to improve the standards of cardiology to clearly identify these multiple consistent recognized barriers, in order to reduce the risk of CHD recurrent events and mortality in Malta.

Mifsud’s research was partially funded by the Strategic Educational Pathways Scholarship (Malta).