Lifestyle Changes after Heart Attack or Stroke in Short Supply

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Carrie Steckl earned her Ph.D. in Counseling Psychology with a Minor in Gerontology from Indiana University – Bloomington in 2001. She has spent over ...Read More

What motivates you to change? For some, it may be a deep desire for something we want. For others, it may be a strong fear of something we don’t want at all. Either way, something has to push toward doing things differently than we’ve been doing them in the past.

I have not experienced a heart attack or stroke, but experts say – and I can imagine – that this would be one of the strongest motivators for a change in lifestyle. Yet a recent study published in the Journal of the American Medical Association found that 1 out of 4 men does not make any lifestyle changes after a cardiac event. The primary lifestyle changes studied were smoking cessation, healthy eating habits, and exercise.


Here are some other unsettling findings from the study, which tracked over 150,000 adults from both rural and urban areas in multiple countries over a 6-year period. Among the 7,519 participants who had a cardiac event:

  • Women were more likely to improve unhealthy behaviors, as were people who lived in urban areas as opposed to rural ones.
  • Only 4.3% of participants who had a cardiac event made changes in all three areas (smoking, diet, and exercise), over 30% changed their behaviors in two areas, and approximately 47% improved their practices in one area.
  • The lifestyle change that people had the most success with was, surprisingly, smoking cessation (52%). Healthy eating followed with 39%, while only 35% of participants said they became more physically active after a cardiac event.
  • Seven percent of women who had a heart attack or stroke made no lifestyle changes, while 26% of men made no changes.
  • Only 10-20% of patients eligible for cardiac rehabilitation programs actually sign up for them.

I highlight these findings not to point a finger at people who have suffered a heart attack, stroke, or other cardiac event. Of course, they usually have the freedom to choose whether to make lifestyle changes, but first they have to know that those changes are necessary. Resources to help them make those changes also must be accessible.

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In an age where the average hospital stay after a heart attack is only one or two days, there’s hardly time for hospital staff to properly educate patients about the changes they need to implement in order to reduce the chances of another cardiac event. Cardiac rehabilitation programs often are not feasible for working adults due to time constraints or other logistical barriers. There also is very little follow-up anymore to ensure that lifestyle changes are maintained. This is particularly true in rural areas where fewer healthcare resources exist.

I urge healthcare providers to evaluate their patient education programs and make any changes necessary to ensure that cardiac patients are receiving the lifestyle assistance they need. Enhancing personal motivation is important, too. If you’ve made a change, tell us how you did it. You just might inspire another cardiac patient to make a lifestyle change that starts them down a fulfilling path to wellness.


Kulash, T. (September 4, 2013). Many stroke, heart attack survivors balk at any changes. Chicago Tribune (Kindle version).

Teo, K., et al. (2013). Prevalence of a healthy lifestyle among individuals with cardiovascular disease in high-, middle- and low-income countries. Journal of the American Medical Association, 309(15), 1613-1621.

Keep Reading By Author Carrie Steckl, Ph.D.
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