Awareness of heart disease among female college students

The Canadian Women's Heart Health Alliance ATLAS on the Epidemiology, Diagnosis, and Management of Cardiovascular Disease in Women - Chapter 7: Sex, Gender, and the Social Determinants of Health

Women vs men have major differences in terms of risk-factor profiles, social and environmental factors, clinical presentation, diagnosis, and treatment of cardiovascular disease. Women are more likely than men to experience health issues that are complex and multifactorial, often relating to disparities in access to care, risk-factor prevalence, sex-based biological differences, gender-related factors, and sociocultural factors. Furthermore, awareness of the intersectional nature and relationship of sociocultural determinants of health, including sex and gender factors, that influence access to care and health outcomes for women with cardiovascular disease remains elusive. This review summarizes literature that reports on under-recognized sex- and gender-related risk factors that intersect with psychosocial, economic, and cultural factors in the diagnosis, treatment, and outcomes of women's cardiovascular health.

Sleep Attributes Influencing Cardiovascular Morbidity Among Young Adults Pursuing Professional Courses in Dehradun, India: A Cross-Sectional Study

Cardiovascular diseases (CVDs) are evolving as a cause of mortality and morbidity among young adults. Young adults, particularly those pursuing professional courses in colleges, face unique challenges that may influence their risk of developing CVD. Despite screening guidelines, CVD risk factors often go undetected in the young population, highlighting the need for increased awareness among adolescents. Sleep is an essential indicator of well-being, and its impact on cardiovascular risk factors is increasingly being recognized. An observational cross-sectional study was conducted among young adults aged 18 to 24 years pursuing professional courses in Dehradun, Uttarakhand, India. A total of 156 participants were recruited through multistage, systematic random sampling, and snowball sampling. Data on sleep patterns and cardiovascular morbidity were collected using a pretested questionnaire. Among the study participants, 46.8% reported having less than four hours of sleep on average, and 25% were suffering from sleep problems. The prevalence of diagnosed CVDs was low, with 6.14% reporting arrhythmias and 3.84% reporting hypertension. An association was found between sleep duration, sleep problems, and the presence of CVDs. Participants with shorter sleep durations and more severe sleep problems had a higher prevalence of CVDs. The findings suggest that sleep duration and sleep problems may be modifiable risk factors for CVDs among young adults. Effective health promotion activities focusing on behavior and lifestyle modifications are essential to preventing CVDs from an early age. The study emphasizes the importance of early intervention and health promotion strategies to reduce CVD risk factors in this population. Community-based research and behavior change communication initiatives are recommended to promote healthy sleep habits and prevent cardiovascular diseases among young adults beyond the college setting.

The apparent need for better communication between clinicians and patients regarding elevated blood pressure among United States emerging adults

Objectives: To examine the discrepancy between 'told' and screened blood pressure (BP) category, and the association between body composition and told BP category. Methods: Between 08/2019-03/2020 college students (n = 1057) were asked what category they had previously been told their BP falls into prior to having their BP and body composition (waist circumference, body mass index (BMI), and body fat percentage) objectively assessed. Results: A disproportionate number (>80%) who were told that they had normal BP were categorized as having elevated BP. Men told they had borderline/high BP had less favorable body compositions than those told they had low/normal BP. Less favorable body composition was associated with increased likelihood of men being told that they had borderline/high BP. Conclusions: Better BP screening policies and procedures would ensure healthcare providers discuss elevated BP with emerging adults regardless of body composition and avoid missing opportunities to delivery of early and cost-effective interventions.

Assessing the Cardiovascular Health Status and Knowledge Level of College Students

Background. Statistics show that the cardiovascular health (CVH) of young Michigan residents is problematic, yet little is known about the CVH of Michigan's college students. This study sought to (1) estimate the prevalence of ideal levels of CVH metrics among college students, (2) assess their CVH knowledge, and (3) examine the association between students' CVH knowledge level and sociodemographics on their CVH behaviors. Methods. A cross-sectional survey was administered online from August 2017 to April 2018. The survey included questions related to students' demographic characteristics, CVH behaviors, presence of CVH factors, and knowledge of ideal levels for CVH metrics. The study included 341 Oakland University students aged 20 to 40 years. Descriptive statistics estimated students' CVH status and knowledge of CVH measures. Generalized ordinal logistic regression analyses examined the association between students' CVH knowledge level and sociodemographic characteristics on their CVH behaviors. All analyses were performed using STATA MP14. Results. More than 87% of the participants did not have an ideal body mass index level. Students' CVH knowledge score significantly decreased (odds ratio = 0.80, 95% confidence interval = 0.67-0.96) with each increase in the number of non-ideal CVH behaviors performed. Conclusions. Michigan college students may benefit from lifestyle interventions that improve their knowledge of CVH and promote ideal CVH behaviors.

Heart checks in college-aged students link poor sleep to cardiovascular risk

OBJECTIVE

To describe the relationships between the cardiovascular health, lifestyle behaviors, and lifestyle beliefs among college-aged students.

PARTICIPANTS

Seven hundred and twenty-nine college-aged students participated between October 2016 and April 2017.

METHODS

Heart checks, consisting of a cross-sectional survey and biometric screening, were conducted on a large Midwestern university campus.

RESULTS

A small proportion of students (24.5%) engaged in the recommended 150+ minutes of physical activity per week and 7.9% consumed 5+ servings of fruit/vegetables daily. Half (49.6%) slept 7 hours or less per night. Biometric screenings found that 26.4% of the students had high stress, 31.9% were overweight or obese, and 17.3% had prehypertension or hypertension. Less sleep was significantly associated with higher risks of being stressed, being overweight/obese, and having elevated blood pressure.

CONCLUSIONS

Early detection, treatment, and education is critical to identify individuals at risk for cardiovascular disease and to promote healthy lifestyle changes before heart disease develops or progresses.

Subjective Life Expectancy Among College Students

Establishing healthy habits in college is important for long-term health. Despite existing health promotion efforts, many college students fail to meet recommendations for behaviors such as healthy eating and exercise, which may be due to low perceived risk for health problems. The goals of this study were to examine: (1) the accuracy of life expectancy predictions, (2) potential individual differences in accuracy (i.e., gender and conscientiousness), and (3) potential change in accuracy after inducing awareness of current health behaviors. College students from a small northeastern university completed an electronic survey, including demographics, initial predictions of their life expectancy, and their recent health behaviors. At the end of the survey, participants were asked to predict their life expectancy a second time. Their health data were then submitted to a validated online algorithm to generate calculated life expectancy. Participants significantly overestimated their initial life expectancy, and neither gender nor conscientiousness was related to the accuracy of these predictions. Further, subjective life expectancy decreased from initial to final predictions. These findings suggest that life expectancy perceptions present a unique-and potentially modifiable-psychological process that could influence college students' self-care.

Assessment of Knowledge of Critical Cardiovascular Risk Indicators among College Students: Does Stage of Education Matter?

The health risk of college students in the United States (US) is on the rise, with a significant increase in the prevalence of cardiovascular risk factors. Cardiovascular disease is the leading cause of death in the US, costing approximately $475.3 billion yearly. The goals of this “Know Your Numbers” study were to: (1) estimate the awareness of college students of their critical health numbers (CHN); and (2) compare a college of pharmacy entry class (IP1) with second semester non-commuter freshman college students (FCS) in knowing their numbers. A cross-sectional 15-item pre-test survey was conducted among a convenience sample of IP1 and FCS. All statistical tests were performed at α = 0.05. Awareness of their: cholesterol (7%), blood pressure (BP) (35%), glucose (8%), and body mass index (BMI) (42%) were low. The IP1, compared to FCS, were more knowledgeable of: (1) their BP (46% vs. 28%, p = 0.01); (2) BP normal range (74% vs. 63%, p = 0.02); and (3) BMI normal range (39% vs. 23%, p = 0.04). The IP1s maintained a healthier diet than the FCS (64% vs. 36%, p < 0.0001). Awareness of knowing CHN was very low. Knowledge of one’s CHN was significantly associated with knowledge of normal reference values for BP, glucose, and BMI.

Validation of the Knowledge and Perception of Cardiovascular Risk Factors Questionnaires for College Students

BACKGROUND AND PURPOSE

To test the psychometric properties of two measures of knowledge and perception of cardiovascular risk factors (CRFs).

METHODS

A methodological study using a modified version of the Heart Disease Fact Questionnaire (HDFQ) and the Health Beliefs Related to Cardiovascular Disease (HBCVD) questionnaires was administered to 100 college-aged students.

RESULTS

The HDFQ Kuder-Richardson-20 reliability estimate was .73. The HBCVD Cronbach's alpha was .70. Principal component analysis demonstrated the HBCVD questions load onto components representing the perceived susceptibility and severity of CRFs. There was an inverse relationship between knowledge and perception of CRFs (ρ = -.26, p = .009), as knowledge increased, perception of risk decreased.

CONCLUSIONS

The HDFQ and HBCVD questionnaires had adequate internal consistency reliability and documented construct validity for use in college students.

Motivations, Barriers, and Behaviors Related to Obtaining and Discussing Family Health History: A Sex-Based Comparison Among Young Adults

Background

Genetic predisposition is a risk factor for many chronic diseases, yet little is known about the frequency in which college students seek out their family health history or with whom they communicate relevant information.

Purpose

This study examines motivations and barriers associated with obtaining one’s family health history and discussing it with others.

Methods

Data were analyzed from 625 college students using an internet-delivered questionnaire, which comprised of questions about intentions and motivations to obtain and share family health history as well as barriers encountered when obtaining family health history. Responses were bifurcated by participants’ sex. Chi-squared and t statistics were used to identify response differences by sex.

Results

Females were significantly more likely than males to be motivated to obtain their family health history, and more likely to have shared their family health history with others; state that they would share their family health history with others; and express a preference for sharing their family health history with a wider range of people.

Discussion

Educational interventions and improved student health services could be effective mechanisms to increase college students’ knowledge, awareness, and perceived importance of obtaining their family health history.

Breast cancer prevention knowledge, beliefs, and information sources between non-Hispanic and Hispanic college women for risk reduction focus

Although growing research focuses on breast cancer screenings, little is known about breast cancer prevention with risk reduction awareness for ethnic differences among college-age women. This study examined breast cancer prevention knowledge, beliefs, and information sources between non-Hispanic and Hispanic college women. Using a cross-sectional study, women at a university in the Southwest completed a 51-item survey about breast cancer risk factors, beliefs, and media and interpersonal information sources. The study was guided by McGuire's Input Output Persuasion Model. Of the 546 participants, non-Hispanic college women (n = 277) and Hispanic college women (n = 269) reported similar basic knowledge levels of modifiable breast cancer risk factors for alcohol consumption (52 %), obesity (72 %), childbearing after age 35 (63 %), and menopausal hormone therapy (68 %) using bivariate analyses. Most common information sources were Internet (75 %), magazines (69 %), provider (76 %) and friends (61 %). Least common sources were radio (44 %), newspapers (34 %), and mothers (36 %). Non-Hispanic college women with breast cancer family history were more likely to receive information from providers, friends, and mothers. Hispanic college women with a breast cancer family history were more likely to receive information from their mothers. Breast cancer prevention education for college women is needed to include risk reduction for modifiable health behavior changes as a new focus. Health professionals may target college women with more information sources including the Internet or apps.

Differences among college women for breast cancer prevention acquired information-seeking, desired apps and texts, and daughter-initiated information to mothers

The purpose of this study was to examine among college women acquired breast cancer prevention information-seeking, desired apps and texts, and information given to mothers. Using a cross-sectional study, a survey was administered to college women at a southwestern university. College women (n = 546) used the Internet (44 %) for active breast cancer prevention information-seeking and used the Internet (74 %), magazines (69 %), and television (59 %) for passive information receipt. Over half of the participants desired breast cancer prevention apps (54 %) and texts (51 %). Logistic regression analyses revealed predictors for interest to receive apps were ethnicity (Hispanic), lower self-efficacy, actively seeking online information, and older age and predictors for interest to receive texts were lower self-efficacy and higher university level. Eighteen percent of college women (n = 99) reported giving information to mothers and reported in an open-ended item the types of information given to mothers. Predictors for giving information to mothers were actively and passively seeking online information, breast self-exam practice, and higher university level. Screenings were the most frequent types of information given to mothers. Breast cancer prevention information using apps, texts, or Internet and daughter-initiated information for mothers should be considered in health promotion targeting college students or young women in communities. Future research is needed to examine the quality of apps, texts, and online information and cultural differences for breast cancer prevention sources.

Assessment of college students' awareness and knowledge about conditions relevant to metabolic syndrome

BACKGROUND

Despite the increasing prevalence of metabolic syndrome among young adults, little is known about the awareness level of college students about this condition. The purpose of this study was to assess students' level of awareness and knowledge about conditions relevant to metabolic syndrome (MetS).

METHODS

A self-reported online questionnaire was administered to 243 students attending Central Michigan University. Questions were divided into seven conditions: diabetes, adiposity, hypertension, high serum cholesterol, arteriosclerosis, stroke, and myocardial infarction. Students' responses were scored and interpreted as follows: poor knowledge if ≤50% of students answered the question correctly; fair knowledge if between 51-80% of students answered the question correctly; and good knowledge if between 81-100% of students answered the question correctly. Anthropometric measurements including height, weight, waist circumference, percentage body fat, and visceral fat score were measured. Fisher's exact test was used to test the differences in students' responses. A p value <0.05 was considered a statistically significant difference.

RESULTS

More than 80% of students correctly identified symptoms and complications of diabetes, hypertension, arteriosclerosis, myocardial infarction and stroke, and 92% identified adiposity as a risk factor for heart disease. There were few false beliefs held by students on questionnaire items. For example, 58% of male students falsely believed that individuals with diabetes may only eat special kinds of sweets compared to 39% of females (p < 0.01) and more than half of the students falsely identified liposuction as the best possible treatment in adiposity therapy. Gender, Health Science major, and year in school were found to be positively associated with more knowledge.

CONCLUSION

The findings in this study suggest that students' knowledge about conditions relevant to metabolic syndrome can be improved. In this essence, raising awareness about MetS based on students' pre-existing knowledge is essential to enhance students' wellness.

Coronary heart disease risk factors in college students

More than one-half of young adults aged 18-24 y have at least 1 coronary heart disease (CHD) risk factor and nearly one-quarter have advanced atherosclerotic lesions. The extent of atherosclerosis is directly correlated with the number of risk factors. Unhealthy dietary choices made by this age group contribute to weight gain and dyslipidemia. Risk factor profiles in young adulthood strongly predict long-term CHD risk. Early detection is critical to identify individuals at risk and to promote lifestyle changes before disease progression occurs. Despite the presence of risk factors and pathological changes, risk assessment and disease prevention efforts are lacking in this age group. Most young adults are not screened and are unaware of their risk. This review provides pathological evidence along with current risk factor prevalence data to demonstrate the need for early detection. Eighty percent of heart disease is preventable through diet and lifestyle, and young adults are ideal targets for prevention efforts because they are in the process of establishing lifestyle habits, which track forward into adulthood. This review aims to establish the need for increased screening, risk assessment, education, and management in young adults. These essential screening efforts should include the assessment of all CHD risk factors and lifestyle habits (diet, exercise, and smoking), blood pressure, glucose, and body mass index in addition to the traditional lipid panel for effective long-term risk reduction.

Metabolic syndrome: comparison of prevalence in young adults at 3 land-grant universities

OBJECTIVE

The study examines metabolic syndrome (MetS) among college students at 3 geographically distinct US campuses.

PARTICIPANTS

Undergraduates (N = 360; 68% women), 18 to 24 years of age, were recruited at each public university in January and February 2011. MetS prevalence was evaluated in 83% (n = 299) participants.

METHODS

Anthropometric, biochemical, and clinical measures were collected in the fasted state.

RESULTS

Twelve percent of college men and 6% of college women met the clinical definition of MetS. Males were more likely to have ≥ 2 individual MetS criteria than females (33% vs 16%; p < .05). Prevalence and individual criteria of MetS differed between the 3 regions. Obese and overweight students met significantly more MetS criteria and had higher C-reactive protein levels than normal-weight students (both p < .05).

CONCLUSION

Findings suggest that MetS prevalence among college students differs by sex, weight status, and region. Further research is needed to identify effective, targeted interventions that are regionally appropriate for this population.

Cardiovascular fitness, activity, and metabolic syndrome among college men and women

BACKGROUND

The purpose of this cross-sectional study was to examine the impact of below-average cardiovascular fitness and inactivity on the metabolic syndrome among an understudied population-undergraduate men and women, ages 18-24 years.

METHODS

Between January, 2010, and May, 2012, we assessed anthropometric, biochemical, and clinical measures in a convenience sample of students (n=1610) enrolled in an introductory nutrition course at a public university. We quantified the prevalence of metabolic syndrome criteria, estimated cardiovascular fitness via a 1-mile Rockport Walk Test, and evaluated daily activity via pedometer. Subjects were classified as below-average, average, and above-average fitness based upon the Rockport Walk Test; activity levels were classified as low active, somewhat active, active, or highly active according to average steps per day.

RESULTS

Those with below-average fitness (10%) were at increased risk for being overfat, having abdominal obesity, and having the metabolic syndrome as compared to those with average or above-average fitness (odds ratio: 12.4, 10.0, and 4.7, respectively; all P<0.01). Twenty percent of subjects were low active (<7500 steps/day) and had a greater number of metabolic syndrome criteria as compared to very active subjects (>12,500 steps/day) (0.94±0.05 vs. 0.73±0.05, P=0.01).

CONCLUSIONS

Young, college-age adults with below-average cardiovascular fitness and/or low activity levels are at increased risk for obesity and the metabolic syndrome. Future studies should examine how promoting lifestyle habits that increase physical activity and reduce sedentary behaviors during the young adult years can improve metabolic health.

Racial/ethnic and age differences in women's awareness of heart disease

BACKGROUND

The purpose of this study was to examine differences in awareness of heart disease among women according to race/ethnicity by age group, adjusted for confounders.

METHODS

American Heart Association (AHA) National Surveys conducted in 2006 (n=1005) and 2009 (n=1142) were pooled using common variables (n=2147) and reweighted to reflect the 2010 United States Census. Surveys comprised standardized, interviewer-assisted demographic and awareness questions. Associations between racial/ethnic group and heart disease awareness stratified by age were assessed by weighted chi-square statistics; logistic regression was used for multivariable adjustment.

RESULTS

Black and Hispanic women were 66% less likely than white women to be aware that heart disease is the leading cause of death in women (odds ratio [OR] 0.34, 95% confidence interval [CI] 0.23-0.50) after multivariable adjustment for significant confounders. The percent aware among white women was 65%; awareness did not differ between black and Hispanic women (37% vs. 38%). Other significant multivariable predictors included <high school education (OR 0.37, 95% CI 0.22-0.62) and income <$35,000/year (OR 0.56, 95% CI 0.41-0.77). Younger women (age<55 years) were less likely to be aware that heart disease is the leading cause of death in women (OR 0.66, 95% CI 0.50-0.87) and were less likely to report being very well/well informed about heart disease (OR 0.53, 95% CI 0.41-0.68) compared to older women (age≥55 years). Awareness of heart attack signs, such as shortness of breath (34%), nausea (15%), and fatigue (7%), was low among all women.

CONCLUSIONS

Racial/ethnic minority status and age<55 years were significant risk factors for lower heart disease awareness among women, suggesting these groups should be targeted for educational programs. Awareness of heart attack signs was low among all subgroups of women.