Women at risk for cardiovascular disease lack knowledge of heart attack symptoms

Clin Cardiol. 2013 Mar;36(3):133-8. doi: 10.1002/clc.22092. Epub 2013 Jan 21.

Abstract

Background: It is not known whether cardiovascular disease (CVD) risk level is related to knowledge of the leading cause of death of women or heart attack symptoms.

Hypothesis: Women with higher CVD risk estimated by Framingham Risk Score (FRS) or metabolic syndrome (MS) have lower CVD knowledge.

Methods: Women visiting primary care clinics completed a standardized behavioral risk questionnaire. Blood pressure, weight, height, waist size, fasting glucose, and lipid profile were assessed. Women were queried regarding CVD knowledge.

Results: Participants (N = 823) were Hispanic women (46%), non-Hispanic white (37%), and non-Hispanic black (8%). FRS was determined in 278: low (63%), moderate (29%), and high (8%); 24% had ≥3 components of MS. The leading cause of death was answered correctly by 54%, heart attack symptoms by 67%. Knowledge was lowest among racial/ethnic minorities and those with less education (both P< 0.001). Increasing FRS was inversely associated with knowing the leading cause of death (low 72%, moderate 68%, high 45%, P = 0.045). After multivariable adjustment, moderate/high FRS was inversely associated with knowing symptoms (moderate odds ratio [OR] 0.52, 95% confidence interval [CI]: 0.28-0.98; high OR 0.29, 95% CI: 0.11-0.81), but not the leading cause of death. MS was inversely associated with knowing the leading cause of death (P< 0.001) or heart attack symptoms (P = 0.018), but not after multivariable adjustment.

Conclusions: Women with higher FRS were less likely to know heart attack symptoms. Efforts to target those at higher CVD risk must persist, or the most vulnerable may suffer disproportionately, not only because of risk factors but also inadequate knowledge.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Chi-Square Distribution
  • Cross-Sectional Studies
  • Ethnicity
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Logistic Models
  • Middle Aged
  • Multivariate Analysis
  • Myocardial Infarction / ethnology
  • Myocardial Infarction / etiology*
  • Myocardial Infarction / mortality
  • Myocardial Infarction / prevention & control
  • New York City / epidemiology
  • Odds Ratio
  • Patient Education as Topic*
  • Primary Health Care
  • Risk Assessment
  • Risk Factors
  • Sex Factors
  • Surveys and Questionnaires
  • Vulnerable Populations
  • Women's Health*