Deficits in adherence on all levels. Current need of interventions in primary, secondary, and tertiary prevention of cardiovascular diseases

Background and objective: Previous studies often lack any differentiation between target groups for primary, secondary and tertiary prevention of cardiovascular disease (CVD). The aim of this study was to investigate the target group-specific adherence with lifestyle recommendations in different risk groups. This information may be useful in identifying better starting points for future CVD interventions. Methods: 2,002 men and women aged 50 to 70 years were selected by random and interviewed about their health status, health behavior and health locus of control. Adherence was defined as regular physical activity, healthy diet, non-smoking, and moderate alcohol consumption. Differences between risk groups were determined using Chi-square tests and stratified logistic regression. Results: Health behavior only varied to a limited extent between the risk groups: physical activity (77.8%), healthy diet (62.2%), moderate alcohol consumption (74.4%), non-smoking (total: 75.7%; healthy respondents 70.9%; risk group 79.1%; CVD patients 74.7%). 29.6% were adherent to lifestyle recommendations. Women were more likely to be adherent than men (35.4% vs. 23.5%). In CVD patients, those living together with a partner were also more likely to have a healthy lifestyle (32.2% vs. 20.0%). Furthermore, health locus of control seems to be an important factor. Conclusion: In the age group 50-70 adherence with lifestyle recommendations of almost 30% is rather low and not optimal. Health locus of control as motivational barrier should be taken into account particularly in secondary prevention. There is a need of health behavior interventions not only for persons at increased risk and CVD patients, but also for the (still) healthy. Men, singles and persons with external health locus of control should be particularly addressed by these interventions.