Heart attack survivors struggle to make lifestyle changes

By June Shannon Heart News   |   21st Oct 2019

Many heart attack patients struggle with issues such as high blood pressure, weight, and smoking cessation after their heart attack, putting them at increased risk of another event.

Almost half of people who smoked at the time of their heart attack continued to smoke up to two years later and many heart attack survivors in Ireland continue to struggle with conditions that significantly increase their risk of having another heart attack, such as high cholesterol, high blood pressure and obesity a new study has found.

According to a new nationwide study of Irish patients who have survived a recent heart attack, while many have tried to change their habits, others are not succeeding in minimising the risk factors which contributed to the heart attack in the first place.

The survey on the control of cardiovascular risk factors in patients who have recently survived a heart attack (called the IAspire study) involved a total of 721 patients with a recent heart attack who were interviewed across 9 centres in Ireland , between Autumn 2018 and Spring 2019.

The finding revealed that 43 per cent of those who smoked at the time of the heart attack are still smoking and 39 per cent were obese up to two years months after their heart attack. Overall just under 10 per cent of the group were currently smokers, but the 43 per cent represented patients who continued to smoke after a heart attack.

Of those who were obese, more than 30 per cent had never been told that they were overweight by a medical professional and 31 per cent reported to never or rarely taking part in regular activity long enough to work up a sweat.

“Survival of a heart attack is a second chance at life, but only if risk factors are managed,"

Professor Bill McEvoy, Professor of Preventive Cardiology, NUI Galway

The survey also revealed that 40 per cent of heart attack patients still had high blood pressure; despite nearly 22 per cent measuring their blood pressure at home, more than half or 56 per cent of heart attack survivors did not reach the goal of reducing their LDL cholesterol to below 1.8mmol/L and of those with diabetes, 39 per cent did not manage to lower their blood sugars to the recommended level.

Furthermore the survey found that almost half or 44 per cent of heart attack survivors did not get the flu vaccine last year despite the fact that the flu can be a trigger for heart attacks and 87 per cent were attending a cardiac prevention or rehabilitation programme for at least half of the sessions.

The survey also found that there was wide variability in risk factor control across the nine sites involved in the survey which led the researchers to suggest that a standardised national cardiovascular prevention programme would be one solution to generally poor control of risk factors seen among Irish heart attach survivors.

“This research shows that in certain aspects our health system is making a positive difference to the lives of patients who have recently survived a heart attack. However, many patients are still struggling with blood pressure, weight, cholesterol, exercise and smoking cessation issues,” said Professor Bill McEvoy, Professor of Preventive Cardiology, NUI Galway and Medical and Research Director, National Institute for Prevention of Cardiovascular Health.

“Survival of a heart attack is a second chance at life, but only if risk factors are managed. While we’re seeing better lifestyle habits in some patients, a considerable proportion – if not half – of Irish heart attack survivors are still not making the changes required to prolong their lives. The health system also needs to do more to standardize care for these patients,” concluded Prof McEvoy.

" It’s important that we use this information to investigate the barriers preventing people attending cardiac rehabilitation and reaching their risk factor targets so that any issues can be addressed,”

Dr Angie Brown, Medical Director , The Irish Heart Foundation

Commenting Dr Angie Brown, Consultant Cardiologist and Medical Director of the Irish Heart Foundation said, the study represented a rich repository of data on Irish risk factors in patients following a cardiac event.

“The mortality from cardiovascular disease has dropped significantly but it is of concern that even following a heart attack many individuals have poor risk factor control that will increase their risk of having another event. It’s important that we use this information to investigate the barriers preventing people attending cardiac rehabilitation and reaching their risk factor targets so that any issues can be addressed.”

These findings were presented by Prof McEvoy at the Irish Cardiac Society Annual Scientific Meeting and AGM, which took place in Galway from Friday, 18th to Sunday 20th October 2019.

The vast majority or 97 per cent of the heart attack survivors’ group had received surgical intervention to either bypass or open up coronary arteries.

According to the researchers, “This indicates good acute care of the condition in Ireland. However, control of risk factors is critical to reduce the chances of a repeat heart attack and in that context the findings of this study are very concerning.”

The IAspire study is a cross-sectional nationally representative survey of the control of cardiovascular risk factors in patients who have recently survived a heart attack. It is an extension of the pan-European survey EuroAspire (I, II, II and IV).

For information on ways to keep your heart healthy please see here 

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cardiac rehabilitation heart attack high blood pressure high cholesterol Obesity risk factors smoking

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