02/03/2014 12:01 EST | Updated 04/04/2014 05:59 EDT

Heart attack and stroke survivors face barriers to get healthier

Some survivors of a heart attack or stroke struggle to get moving, manage stress and maintain a healthy weight, says a new Canadian report that stresses how important rehabilitation programs and family support can be.

About 165,000 Canadians survived a heart attack or stroke last year, but there are still 350,000 hospitalizations for the diseases each year, the Heart and Stroke Foundation said in its report released Monday.

The report includes highlights of an online poll of 2,010 Canadians who’d survived a heart attack or stroke, or were the loved ones of survivors.  About seven in 10 survivors said they’d made healthy changes since the scare.

Survivors were most successful in eating a healthier diet, quitting smoking and reducing alcohol consumption.

But among people who needed to make those changes, more than half couldn’t maintain the change and others didn’t try.

"The biggest barrier was related to motivation, which was defined as a lack of interest in making the change, a feeling that the goals were unrealistic and that there was too much required all at once," the report’s authors said.

Other barriers included not understanding what changes were needed or how to make them, loss of physical or cognitive abilities since the event, and cost and time constraints.

The report’s authors also looked at how to support recovery, calling rehabilitation referral rates "unacceptably low." Evidence shows that about one-third of cardiac survivors who are eligible for rehabilitation are referred.

The main reason people gave for not starting or completing rehabilitation as recommended was, "I just didn’t want to do it," which can be an indicator of other factors such as anxiety, depression and lack of a clear endorsement from their doctor on the benefits.

"The number 1 benefit of rehabilitation is that it keeps survivors surviving," Dr. Neville Suskin, medical director of cardiac rehabilitation and secondary prevention at St. Joseph's Health Care in London, Ont., said in a release. Suskin pointed to other benefits: it makes people feel better, improves their quality of life, and reduces hospital readmissions as well as costs to the health-care system.

More than eight in 10 survivors said they feel that their family support helped them achieve a healthy lifestyle, such as assisting with chores during recovery and keeping stress levels in check.

The poll was conducted online by Environics Research Group between Nov. 25 and Dec. 3, 2013.