Predictors of cardiovascular health improvements in patients at risk of cardiovascular disease: A cross-sectional analysis of Green Prescription

Abstract

Aim: To determine the factors predicting cardiovascular health improvements among patients reporting cardiovascular disease (CVD) risk. Methods: The study was based on New Zealand’s exercise prescription programme, Green Prescription (GRx). Using the 2016 GRx Patient Satisfaction Survey, cross sectional data were collected from patients who were referred to GRx in 2015 (n = 2843). Results: Included in analysis were 71% of total respondents who reported one or more CVD risks, namely weight problems (n = 1463), high blood pressure/risk of stroke (n = 681), high cholesterol (n = 496), Type 2 diabetes (n = 463), pre-diabetes (n = 350), heart problems (n = 310) and/or smoker (n = 128). There were 50.5% reporting no CVD-related health improvements and 49.5% reporting 1-5 improvements. A linear regression indicated 11 of 30 variables predicted cardiovascular health improvements (adj R2 = .214, p <.001). Pearson’s correlations indicated cardiovascular health improvements were positively related to reporting more CVD risk factors (r=.28), changing one’s diet (r=.25), spending more time being active (r=.19), receiving a GRx extension in past year (r=.17), gardening (r=.14), cycling (r=.13), exercising with adult family members (r=.12), being male (r=.12), receiving one’s first GRx over 6 months ago (r=.11), exercising in a sports club (r=.10) and exercising with friends (r=.09) (all p <.001). Conclusions: Patients reporting more CVD risk factors showed the highest correlation with cardiovascular health improvements. Patients who changed their food and drink intake as a result of GRx revealed the second strongest correlation with cardiovascular health improvements. Other results suggest that lifestyle physical activity such as gardening and cycling combined with social components of exercising with family, friends and in a sports club are the most promising factors for improving the cardiovascular health of patients at risk of CVD.