Evaluation of lifestyle change in patients with cardiovascular event in an Italian regional hospital

BACKGROUND: Lifestyle change is one of the tertiary measures undertaken to prevent a new Cardiovascular Event (CVE). In order to evaluate critical issues and undertake actions aimed at improving preventive strategies, we carried out a cross-sectional survey to assess post-CVE lifestyle in patients aged 18-79 years affected by CVE in the 5 years prior to their current admission to Miulli Hospital (Acquaviva delle Fonti, Italy) (702 beds, 64 wards). METHODS: Consecutive patients were enrolled (10/20/22-4/4/23). Data were collected by means of an anonymous questionnaire based on literature. Patients were matched, according to gender, age and level of education, with two control groups: one constituted by healthy controls (ratio 1:10) and the other by CVE patients (ratio 1:2) involved in the European Health Interview Survey (EHIS). RESULTS: Forty-two subjects (a number suitable for statistical analysis) were enrolled (73.8% male). They ate fruit and vegetables at least once/day, with an increase from the pre-CVE period (fruit: 61.9% vs 69%; vegetables: 59.5% vs 66.7%) to levels similar to healthy subjects (fruit: 71.7%; vegetables: 66%). Comparison with the CVE EHIS group revealed lower fruit consumption (69% vs 78.6%) but higher vegetable consumption (66.7% vs 52.4%). The proportion of those who did not use alcohol increased after CVE (64.3% vs 69%) to higher levels than in the control groups (healthy subjects: 56.9%; CVE EHIS group: 61.9%). Fish consumption increased from 1-3 times/week (45.2% vs 38.1%) to 4-6 times/week (23.8% vs 33.3%). Red meat consumption decreased from 4-6 times/week (33.3% vs 14.3%) to 1-3 times/week (50% vs 64.3%). A reduction in smoking followed CVE similarly to the EHIS population (90.5% VS 84.5%). No improvement in physical activity was recorded. CONCLUSIONS: The activities of tertiary prevention undertaken yielded a lifestyle improvement in post-CVE patients, who adopted similar habits to those of healthy subjects. KEY MESSAGES: • In post-CVE patients, preventive measures can be enhanced through medical counseling at the time of discharge. • Lifestyle surveillance in post-CVE patients should be strengthened.