Following Through with Healthy Living

Heart disease and stroke patients worldwide neglecting lifestyle changes

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Many people have been told by physicians to improve their lifestyle choices – quit smoking, eat better, exercise – especially if there has been a history of health problems. The question is, how many people actually follow through and make these changes?

A new study exploring coronary heart disease and stroke patients worldwide found low levels of these healthy lifestyle behaviors and even lower rates in poorer countries.

"Exercise several times a week."

Researchers, led by Koon Teo, MB (Bachelor of Medicine), PhD, of McMaster University in Hamilton, Ontario, utilized data from the large Prospective Urban Rural Epidemiology (PURE) study that took place between January 2003 and December 2009.

The current study included 153,996 adults between the ages of 35 and 70 from a total of 628 different communities. The communities were in 17 different countries that represented a range of income levels. 

Participants self-reported past health events, including coronary heart disease and stroke. Smoking status, exercise levels and diet were also assessed.

Of the 7,519 people with a history of coronary heart disease or stroke, 52.2 percent had quit smoking, but 18.5 percent continued to smoke.

Researchers found that 39 percent were considered to have healthy diets and 35.1 percent had high levels of physical activity (either work or leisure related).

Dr. Teo and team also found that 14.3 percent of these patients did not participate in any of the three lifestyle behaviors explored. By contrast, only 4.3 percent made all three lifestyle choices – quit smoking, high exercise levels and healthy diets.

The bad habits seemed more prevalent in lower-income countries. “These patterns were observed worldwide but more so in poorer countries,” wrote the authors.

In an interview with dailyRx News, Sarah Samaan, MD, cardiologist and physician partner at The Baylor Heart Hospital in Plano, Texas, said that getting patients to follow through with these behaviors can be difficult.

“People are extremely resistant to change, even when they know how harmful their lifestyle choices can be,” said Dr. Samaan.

“We doctors are very good at diagnosing problems, doing procedures and surgeries and prescribing medications,” said Dr. Samaan. “But exercising daily, eating more healthfully and quitting smoking are up to the individual."

Dr. Samaan continued, “While many studies have looked at ways to help motivate people to exercise, eat healthier and quit smoking, there is no one-size-fits-all approach. These changes require effort and time, but the payoff in better health and vitality is huge.”

The authors of this study concluded that there is a large, global gap between ideal behaviors and actual behaviors following coronary heart disease or stroke. “This requires development of simple, effective and low-cost strategies for secondary prevention that is applicable worldwide,” they suggested.

The study was published online on April 17 by the Journal of the American Medical Association. Several authors reported connections to a variety of different pharmaceutical companies and research institutions.

Reviewed by: 
Review Date: 
April 18, 2013
Last Updated:
August 14, 2013