Cultural factors and patients' adherence to lifestyle measures.

BACKGROUND Non-adherence to preventive and therapeutic lifestyle recommendations among patients at high risk of cardiovascular disease is more prevalent and varied than previously thought. The problem needs to be addressed by those who are involved in the care of these patients. AIM To measure adherence and barriers of complying with lifestyle recommendations among patients with high cardiovascular risk factors. DESIGN OF STUDY Prospective study. SETTING Six family-practice health centres in Kuwait. METHOD Data are from 334 Kuwaiti adult males and females with hypertension, type 2 diabetes, or both, who completed a routine clinic visit in one of six family practice centres. Trained staff used a structured questionnaire to obtain a detailed medical history regarding exercise habits and barriers to compliance with diet and exercise programmes. Clinical criteria assessed were height, weight, and the control of blood pressure and blood sugar. RESULTS From the study sample, 63.5% of patients reported that they were not adhering to any diet regimen, 64.4% were not participating in regular exercise, and 90.4% were overweight and obese. The main barriers to adherence to diet were unwillingness (48.6%), difficulty adhering to a diet different from that of the rest of the family (30.2%), and social gatherings (13.7%). The main barriers to adherence to exercise were lack of time (39.0%), coexisting diseases (35.6%), and adverse weather conditions (27.8%). Factors interfering with adherence to lifestyle measures among the total sample were traditional Kuwaiti food, which is high in fat and calories (79.9%), stress (70.7%), a high consumption of fast food (54.5%), high frequency of social gatherings (59.6%), abundance of maids (54.1%), and excessive use of cars (83.8%). CONCLUSION The majority of individuals in the sample were overweight, did not engage in recommended levels of physical activity, and did not follow dietary recommendations. Additional cultural and demographic variables need to be considered to improve adherence to lifestyle measures.