Address Cardiovascular Disease Risk Research Articles

Cardiovascular risk factor awareness in a disadvantaged inner-city population – implications for preventive strategies

Disadvantaged inner-city populations have significantly higher cardiovascular disease (CVD) mortality rates than the general population. Whether a deficiency in the level of awareness, a prerequisite for change, exists that contributes to this socioeconomic divide has not been well established. To address CVD risk by assessing the knowledge of CVD risk factors of an inner-city population and comparing it with that of the general population by establishing determinants of CVD knowledge and identifying potential barriers to CVD risk factor reduction in the inner city. Cross-sectional survey of 136 consecutive patients 40 years of age and older attending an inner-city community health centre. The comparison group consisted of 807 age-matched respondents from the Canadian Heart Health Study, a random sample survey of the general adult Canadian population. Outcome measures included CVD risk factor knowledge, CVD risk factor prevalence and barriers to reducing CVD risk. There was no significant difference between inner-city respondent ability to name five of the seven CVD risk factors compared with the general population. Two CVD risk factors were more readily recalled by the inner-city group (lack of exercise, P<0.001; heredity, P=0.003). The average number of risk factors named by an individual from the inner city was significantly higher than the general population (3.1 versus 2.6; P<0.001). Among the inner-city respondents, socioeconomic factors, including higher education level (OR 5.224; P<0.001) and being married (OR 3.651; P=0.008), were independently related to good CVD knowledge; high CVD risk was not related. Lack of motivation (57%), lack of time (34%) and lack of money (30%) were commonly reported as barriers to addressing CVD risk. Elevated CVD risk in the inner city may not be attributable to a deficiency in the level of awareness. However, the relationship between socioeconomic status and knowledge is maintained within the lowest social class tier. The identification of barriers linked to inner-city life has implications for prevention of CVD in the inner city; results suggest that interventions that combine health education with motivational approaches, while necessary, may not be sufficient.

Cardiovascular Disease

Health IssueCardiovascular disease (CVD) is the leading cause of death in Canadian women and men. In general, women present with a wider range of symptoms, are more likely to delay seeking medial care and are less likely to be investigated and treated with evidence-based medications, angioplasty or coronary artery bypass graft than men.Key FindingsIn 1998, 78,964 Canadians died from CVD, almost half (39,197) were women. Acute myocardial infarction, which increases significantly after menopause, was the leading cause of death among women.Cardiovascular disease accounted for 21% of all hospital admissions for Canadian women over age 50 in 1999. Admissions to hospital for ischemic heart disease were more frequent for men, but the mean length of hospital stay was longer for women.Mean blood pressure increases with age in both men and women. After age 65, however, high blood pressure is more common among Canadian women. More than one-third of postmenopausal Canadian women have hypertension.Diabetes increases the mortality and morbidity associated with CVD in women more than it does in men. Depression also contributes to the incidence and recovery from CVD, particularly for women who experience twice the rate of depression as men.Data Gaps and RecommendationsCVD needs to be recognized as a woman's health issue given Canadian mortality projections (particularly heart failure). Health professionals should be trained to screen, track, and address CVD risk factors among women, including hypertension, elevated lipid levels, smoking, physical inactivity, depression, diabetes and low socio-economic status.