Abstract 11960: Women at High Risk for Cardiovascular Disease Lack Basic Cardiovascular Disease Knowledge

Abstract

BACKGROUND: Despite advances in care and improved awareness, heart disease remains the leading cause of death among women and knowledge of heart attack symptoms remains suboptimal, particularly in minority women. It is not known whether cardiovascular disease (CVD) health literacy is related to CVD risk estimated by Framingham Risk Score (FRS) or Metabolic Syndrome (MS). Our goal was to examine this association.

METHODS: Women (n=823) without known CVD attending Columbia University primary care clinics completed a standardized questionnaire. Blood pressure, weight, height and waist size were measured; chart review was used to determine fasting glucose and lipid profile; demographic data and responses regarding knowledge of the leading cause of death among women and symptoms of heart attack were determined. Participants were characterized as having low, moderate or high FRS; presence of MS was determined.

RESULTS: Of the 823 participants, 382 (46%) were Hispanic, 301 (37%) Non-Hispanic White, and 140 (17%) Black, Asian or other. Mean age was 48 ± 15 years and mean education was 14 ± 4 years. FRS was determined in 278 women; 175 (63%) were low risk, 81 (29%) moderate risk, and 22 (8%) high risk. We characterized 322 for the components of MS; 76 (24%) had ≥3 components of MS. The leading cause of death was answered correctly by 445 of 819 (54%). Increasing FRS was associated with decreased likelihood of knowing the leading cause of death (low 72%, moderate 68%, high 45%, p=0.045). Participants with MS were less likely than those without MS to know the leading cause of death (39% vs. 72%, p<0.001). The symptoms of a heart attack was answered correctly by 548 of 820 (67%). Increasing FRS was associated with decreased likelihood of knowing symptoms of heart attack (low 75%, moderate 61%, high 41%, p<0.001). Women with MS were less likely than those without MS to know symptoms of heart attack (55% vs. 70%, p=0.018).

CONCLUSIONS: Women with higher FRS and MS are less likely to know the leading cause of death and symptoms of heart attack than their low risk counterparts. Efforts to target those at high risk for CVD must persist or the most vulnerable may continue to suffer disproportionately, not only because of their risk profile, but also because of inadequate knowledge.