Stability and change of lifestyle profiles in cardiovascular patients after their first acute coronary event

Abstract

BackgroundAcute coronary syndrome (ACS) is a major cause of morbidity and mortality. Lifestyle and health behavior changes play an important role in the primary and secondary prevention of ACS recurrence. Changes in unhealthy lifestyles after an acute coronary event have been analyzed by considering separate behaviors individually, even though research on the healthy population has demonstrated that unhealthy behaviors tend to co-occur.PurposeThe aim of this study was to identify lifestyle profiles of ACS patients and to explore their pathways of change for one year after their first coronary event by adopting a typological approach.MethodsTwo hundred and twenty-three patients (84% male; mean age = 57.14) completed self-report measures of health-related behaviors at the beginning of cardiac rehabilitation, and six months and twelve months after. At each wave depression, anxiety and heart rate were also evaluated. Cluster analysis was performed to identify lifestyle profiles and to analyze their change over time. Differences in psychological factors and heart rate among clusters were assessed.ResultsPatients' diet, physical activity, and smoking behavior greatly improved six months after their first coronary event. No further improvements were detected after one year. At each wave specific lifestyle profiles were identified, ranging from more maladaptive to healthier clusters. Patients with multiple unhealthy behaviors experience greater difficulties in maintaining a healthier lifestyle over time. Moreover, the results demonstrated the association between lifestyle profiles at twelve months after the acute coronary event and depression measured six months earlier. Finally, the most maladaptive lifestyle profile had many members with elevated heart rate at twelve months after the cardiac rehabilitation.ConclusionsCurrent findings may have a strong practical impact in the development and implementation of personalized secondary prevention programs targeting lifestyles of ACS patients.

Associations of Psychosocial Factors with Multiple Health Behaviors: A Population-Based Study of Middle-Aged Men and Women

“…Although there are national guidelines for interventions on single behaviors, less support is available for interventions in the more complex situations of multiple health risk behaviors. As described above, engaging in multiple risk behaviors is related to a greater risk of disease than the summated risk for each of the behaviors [10][11][12][13] and, hence, there is a potential gain in multiple health risk behavior interventions.…”

“…Engaging in multiple risk behaviors was shown to constitute a risk of disease development that is greater than the summated risk for each of the behaviors, for both general populations [10] and clinical populations [11]. Individuals with four risk behaviors compared with those who report one risk behavior have a two-fold risk of stroke [12] and three times the risk of coronary vascular disease and cancer mortality [13].…”

A three-year longitudinal study of healthy lifestyle behaviors and adherence to pharmacological treatments in newly diagnosed patients with acute coronary syndrome: hierarchical linear modeling analyses

“…First, we examined if patients would experience longitudinal decreases in adherence to pharmacological treatments, from the 6-month to the 3-year follow-up, as suggested by previous studies that followed cardiovascular patients for 12 months (e.g., Crowley et al 2015;Molloy et al 2014). Second, we examined if patients would experience strong increases in the four lifestyle behaviors from pre-event to 6-months after, and small but significant decreases from the 6-month to the 3-year follow-up, as suggested by previous studies that followed patients for 6 or 12 months (e.g., Chow et al 2010;Kotseva et al 2019;Steca et al 2017;Tang et al 2013). In essence, we expect to replicate findings from previous longitudinal studies in a much longer and unexplored period of time than previously.…”

Combined profiles derived from cardiovascular risk factors, health-promoting lifestyle, and post-traumatic stress disorder symptoms

“…These factors can also play a role in experiencing the symptoms of PTSD in general. 20,26 Regarding the risk factors of CVDs, the results of a previous review confirm the relationship between the frequency and type of risk factors for CVDs, including socio-demographic features of age and gender, history of MI, chest pain, high blood pressure, and psychiatric conditions with experienced PTSD symptoms. 26 The presence of highly risk factors and disability in stress management as one of the components of HPLP can be associated with the increasing experience of PTSD symptoms.…”