Unhealthy behaviours of patients with cardiovascular diseases during the second COVID-19 lockdown in Northern Greece

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Unhealthy behaviours can be amplified during lockdown and organisations, like WHO and CDC, campaign on how to stay healthy at home. Lifestyle choices are of paramount importance for primary and secondary prevention of cardiovascular diseases (CVDs). Northern Greece was forcefully hit by the second wave of the COVID-19 pandemic and a hard lockdown was implemented in November 2020. Purpose The aim of the study was to assess the (un)healthy behaviours of patients with CVDs during the second COVID-19 lockdown in Northern Greece. Methods This is a cross-sectional short questionnaire telephone-based survey conducted in February 2021. Responders with known CVDs were primarily questioned (using a Likert-like scale) about smoking, diet and physical activity, along essential medical history. Beliefs about COVID-19 pandemic and vaccination were also considered. Sociodemographic details were noted. Patients who were placed under quarantine were excluded in this analysis. Results The response rate was high (247 out of 400 calls, 61.8%) with the majority of the participants willing to speak for longer time than initially estimated. In total, answers by 216 patients (female 132/61.1%, mean age 56.6 years old) were incorporated. There were 119 active smokers questioned, half of whom (56, 47.1%) reported increased smoking with a minority of them (18, 15.1%) smoking less. None of the questioned participants attempted to quit smoking. The mean BMI was 27.5 ± 4.3 kg/m² (vs. 26.8 ± 3.8 kg/m² before lockdown) corresponding to a mean weight gain of about 2 kg. The rise in mean BMI could be explained, partly, by the increased eating as reported by almost half of the participants (121, 56.0%). Almost half of the responders (113, 52.3%) reported increased alcohol consumption during the lockdown, while one fifth reported unchanged drinking. One in four patients stated lower alcohol consumption mainly due to difficult supply and bar closure. The majority of the participants (177, 81.9%) answered that they exercised similarly or less in comparison to their pre-lockdown habits, while only 39 (18.1%) have been more physically active. There was no difference between the patients who were favourable about vaccination (had already been vaccinated/ had arranged an appointment/ were willing to get) and those who objected/ were hesitant. Sample size would not allow thorough comparison between age groups or socioeconomic status. Nevertheless, younger patients reportedly adopted healthier choices than older patients (who were also more like to be pensioners). Conclusion The hard lockdown in Greece during the second wave of the COVID-19 pandemic was accompanied with an aggravation of unhealthy choices by patients with CVDs. Further research is warrant to assess the clinical impact of these behaviours. Public campaigns are anxiously needed to promote healthy behaviours.