Changing lifestyle habits as secondary prophylaxis after coronary artery bypass grafting.
BACKGROUND
Many studies have investigated the effect on mortality and morbidity of modified risk factors after coronary artery bypass grafting (CABG). We performed a retrospective survey to evaluate changing lifestyle habits after CABG during 1990-2003, focusing on the correlation between lifestyle habits and freedom from symptoms and regained exercise tolerances.


METHODS
We reviewed data from 2269 patients who had undergone CABG in the year 1990, 1993, 1998, 2000, 2001, 2002, or 2003. Data were collected with a questionnaire that addressed lifestyle modifications and their outcomes with regard to quality of life for up to 5 years after surgery.


RESULTS
We observed significant decreases in changing dietary habits after surgery in patients who had surgery in 2000-2003 compared with patients who had surgery in 1990-1998 (15.9% +/- 1.6% vs 24.7% +/- 2.6%; P < .001). In addition, the desire for nutritional counselling decreased steadily over time (35.1% +/- 7.9% vs 26.6% +/- 1.4%; P <.0001). Notably, among patients 50-59 years old, fewer men than women followed a strict diet (males 20.0% vs females 41.5%; P = .001). Patients suffering from recurrent angina consulted nutritionists more often than patients without angina (36.6% vs 29.8%; P = .016). The more the patients were restricted in terms of physical fitness, as determined by the New York Heart Association (NYHA) class, the more likely they were to adhere to a healthy diet (NYHA III 22.2% vs NYHA II 14.6% vs NYHA I 10.2%; P <.001). Among patients 60-79 years old, men exercised more often than women (72.4% +/- 2.4% vs 51.1% +/- 4.9%; P <.001) and suffered less frequently from recurrent angina (13.4% +/- 4.0% vs 28.8% +/- 10.8%; P = .002).


CONCLUSIONS
Despite knowledge of hypercholesterolemia or obesity as agents contributing to advancing coronary heart disease, attention to nutrition tends to significantly decrease over time in patients who have undergone CABG. Thus patients who have undergone CABG, especially male patients older than 50, years would benefit from dietary education. Similarly, female patients older than 60 years would benefit from increased physical activity. Patients obviously tend to delay lifestyle modification until symptoms occur. Hence they must be reminded of the importance of healthy nutrition and adequate physical activity.
Vachenauer
Robert
R
Department of Cardiac and Vascular Surgery, University Hospital of Zurich, Switzerland. Robert.Vachenauer@usz.ch
Grünenfelder
Jürg
J
Plass
Andre
A
Slankamenak
Ksenija
K
Pantic
Lilijana
L
Kisner
Dilek
D
Genoni
Michele
M
D000367:Age Factors; D000368:Aged; D000787:Angina Pectoris / Q000517:prevention & control; D002784:Cholesterol / Q000097:blood; D001026:Coronary Artery Bypass; D016552:Ergometry; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness; D011184:Postoperative Period; D011315:Preventive Medicine / Q000379:methods*; D011788:Quality of Life; D012189:Retrospective Studies; D055502:Secondary Prevention; D011795:Surveys and Questionnaires
D002784:Cholesterol