AIMS Despite the high use of cardioprotective medications, the risk factor control in patients with coronary heart disease (CHD) is still inadequate. Guidelines identify healthy lifestyles as equally important in secondary prevention as pharmacotherapy. Here, we describe reasons for poor lifestyle adherence from the patient's perspective. METHODS AND RESULTS In the EUROASPIRE IV and V surveys, 16 259 CHD patients were examined and interviewed during a study visit ≥6 months after hospital discharge. Data gathering was fully standardized. The Brief Illness Perception questionnaire was completed by a subsample of 2379 patients. Half of those who were smoking prior to hospital admission, were still smoking; 37% of current smokers had not attempted to quit and 51% was not considering to do so. The prevalence of obesity was 38%. Half of obese patients tried to lose weight in the past month and 61% considered weight loss in the following month. In relation to physical activity, 40% was on target with half of patients trying to do more everyday activities. Less than half had the intention to engage in planned exercise. Only 29% of all patients was at goal for all three lifestyle factors. The number of adverse lifestyles was strongly related to the way patients perceive their illness as threatening. Lifestyle modifications were more successful in those having participated in a cardiac rehabilitation and prevention programme. Patients indicated lack of self-confidence as the main barrier to change their unhealthy behaviour. CONCLUSION Modern secondary prevention programmes should target behavioural change in all patients with adverse lifestyles.

中文翻译：

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冠心病患者对生活方式建议的依从性差：来自 EUROASPIRE 调查的结果。

目的 尽管心脏保护药物的使用率很高，但冠心病（CHD）患者的危险因素控制仍然不足。指南确定健康的生活方式在二级预防中与药物治疗同等重要。在这里，我们从患者的角度描述生活方式依从性差的原因。方法和结果 在 EUROASPIRE IV 和 V 调查中，16 259 名 CHD 患者在出院后 6 个月的研究访问期间接受了检查和访谈。数据收集完全标准化。简要疾病感知问卷由 2379 名患者的子样本完成。入院前吸烟的人中有一半仍在吸烟；37% 的当前吸烟者没有尝试过戒烟，51% 的人没有考虑戒烟。肥胖的患病率为 38%。一半的肥胖患者在过去一个月内尝试减肥，61% 的人考虑在下个月减肥。在身体活动方面，40% 的患者达到了目标，一半的患者试图做更多的日常活动。不到一半的人打算参加有计划的演习。只有 29% 的患者达到了所有三种生活方式因素的目标。不良生活方式的数量与患者认为自己的疾病具有威胁性的方式密切相关。在参与心脏康复和预防计划的人中，生活方式的改变更为成功。患者表示缺乏自信是改变其不健康行为的主要障碍。结论 现代二级预防计划应针对所有不良生活方式患者的行为改变。