Knowledge of the causes of heart attack among survivors, and implications for health promotion

Abstract

This study investigated the beliefs held by survivors of a heart attack about the causes of heart attacks. A survey of survivors was carried out in six coronary care units involved in the Anglo-Scandinavian Study of Early Thrombolysis (ASSET). The results were based on 1283 returned ques tionnaires. Stress or worry were nominated by most people (66 per cent). Only 22 per cent of all patients named smoking as a cause of heart attacks (28 per cent among smokers). Smokers who named smoking as a cause were not significantly more likely to stop smoking within a month than smokers who did not nominate it (78 per cent versus 73 per cent, respectively). The findings were compared to those from a survey of the general population; knowledge of established risk factors was poor in both populations. Smokers were more aware of smoking as a cause than non-smokers in both populations but this knowledge did not appear to affect smoking behaviour soon after the heart attack in the survivors. There were substantial differences in the level of knowledge of some risks in those from lower social classes in the survivor group. Health promotion activity in survivors need not be substantially different from that delivered to the general population but needs to impart more than just knowledge of risk factors to be effective. Survivors who are in lower social classes may have a poorer knowledge base and present a particular challenge.