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The aim of study was to determine reasons for poor adherence to lifestyle recommendations. The objective was to determine: reason for poor adherence to dietary regimen, exercise recommendations, medications, and smoking cessation. Factors affecting adherence to lifestyle changes were categorized into four major categories i.e. socio-demographic factors, cognitive factors, interpersonal factors, unintentional/others. It was found that the major factors responsible for non-adherence were busy schedule, low socioeconomic status, low education level, beliefs, health condition, severe weather condition, cost of medications, side effects of medications, poor memory, lack of motivation, lack of social and family support, unwillingness, tendency to eat out, increasing number of fast food outlet, frequent social gatherings, depression, stress, smoking, patient-physician communication, trust in health-care provider, insufficient information on benefits and use of prescribed medicines and proposed lifestyle changes. No particular intervention strategy can improve the adherence of all patients, research studies reach a conclusion that effective attempts to improve patient adherence depend upon a set of significant factors. Mutual cooperation fosters greater patient satisfaction, lessens the risks of non-adherence, and improves patients' health and fitness.

Keywords: Poor adherence, Lifestyle changes, Cognitive factors, Cardiovascular risk.