COMPLIANCE TO PREVENTION OF ALCOHOL AND TOBACCO USE AS A RISK FACTOR OF RECURRENT MYOCARDIAL INFARCTION.

Introduction: Compliance to treatment is an important condition of treatment quality and effectiveness. Tobacco consumption has been recognized as one of the leading causes of health loss and premature death in both economically developed countries and developing ones. Aim: To study the awareness and compliance to alcohol and tobacco use prevention of patients after myocardial infarction in the residual period of the disease. Materials and Methods: To study awareness of risk factors and compliance to secondary prevention of myocardial infarction (MI), a representative sample was created by randomization, taking into account the proportional distribution in the population by age (under 65 and over 65 years old) and sex. Patients’ awareness of risk factors, use of preventive measures and compliance to treatment were assessed on the basis of a questionnaire. 333 respondents took part in the questionnaire – 234 men (70,27%) and 99 women (29,73%), the average age – 62,5±9,8 years old. Results: Women in the general sample were older (65,8±8,7 years old) than men (61,0 ±9,9 years old) (z=3,97; p=0,0001). The period after myocardial infarction averaged 2,5±1,6 years (from 0,5 to 7,0 years). The average term for the index event for women was 2,7±1,5 years, for men it was 2,4±1,6 years (z=1,60; p=0,1). 299 patients out of 333 (90,99%) answered «Yes» to the question «Do you use any methods to prevent cardiovascular disease, i.e. are you doing anything to reduce the risk of developing or worsening of these diseases?» (90,6% among men and 91,92% among women). In order to determine patients’ awareness of reducing the risk of recurrent heart attack, in terms of tobacco and alcohol use prevention, 15,92% (53 people) were aware that smoking cessation reduces the risk of recurrent heart attack. Among those informed people were 20,09% (47 people) of men and 6,06% (6 people) of women (χ²=9,21; p=0,002). 11,04% (33 people) said that they quit smoking to prevent a heart disease. Among the supporters were men – 14,9% (31 people) and women – 2,2% (2 people) (F p = 0,0004). 16,52% (55 people) were aware that alcohol consumption decreasing reduces the risk of recurrent heart attack. Among those informed people were 20,94% of men (49 people) and 6,06% of women (6 people) (χ²=10,12; p=0,008). 10,70% (32 people) said that they reduced alcohol consumption to prevent a heart disease. Among the supporters were men –13,46% (28 people) and women – 4,4% (4 people) (F p=0,01). It should be noted that 70,27% of respondents received recommendations from their doctors to smoke less or quit smoking, and 73,57% of respondents received recommendations from their doctors to drink less alcohol. Conclusions: Low level of awareness of the possibility of risk factors modifying for recurrent heart attack is associated with a low compliance to non-drug secondary prevention measures after MI such as smoking cessation (F p=0,000) and alcohol reduction (χ²=35,29; p= 0,000). [ABSTRACT FROM AUTHOR]