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Mochari-Greenberger H, Miller KL, Mosca L. Racial/ethnic and age differences in women's awareness of heart disease. J Womens Health (Larchmt) 2012; 21:476-80. [PMID: 22512853 DOI: 10.1089/jwh.2011.3428] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
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.
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Sabbadini G, Travan L, Toigo G. Elderly women with heart failure: unseen, unheard or simply forgotten? ACTA ACUST UNITED AC 2012. [DOI: 10.2217/ahe.12.10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
In developed countries, cardiovascular disease is the leading cause of death among women; one-third of these deaths are directly or indirectly related to heart failure. Women already constitute the majority of heart failure patients and, given their longer life expectancy, the proportion of elderly women with heart failure is likely to increase further. These figures alone should make elderly women with heart failure a medical research and public health priority. On the contrary, they have received, and continue to receive, very little attention. Elderly women have been largely excluded from heart failure clinical trials and, compared with their male counterparts, are under-recognized and less intensively investigated and treated in clinical practice. Elderly women with heart failure are at increased risk for adverse outcomes because of higher comorbidity, psychological distress and socioeconomic disadvantage. Yet, they are often left alone to deal with these problems, which can negatively affect their ability to carry out basic self-care tasks.
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Affiliation(s)
- Gastone Sabbadini
- Department of Medical, Surgical & Health Sciences, University of Trieste, Trieste, Italy
| | - Luciana Travan
- Department of Experimental & Clinical Medicine, University of Udine, Udine, Italy
| | - Gabriele Toigo
- Department of Medical, Surgical & Health Sciences, University of Trieste, Trieste, Italy
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Galbraith EM, Mehta PK, Veledar E, Vaccarino V, Wenger NK. Women and heart disease: knowledge, worry, and motivation. J Womens Health (Larchmt) 2011; 20:1529-34. [PMID: 21797669 DOI: 10.1089/jwh.2010.2356] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Heart disease remains the number one killer of women. Epidemiologic data show a persisting failure to raise the perception of heart disease risk in women despite massive campaigning efforts. We sought to describe the psychosocial barriers preventing women from recognizing this risk and actively preventing heart disease. METHODS We obtained access to data from the 534 participants of a random sampling of U.S. women from a commercial telephone survey commissioned by a nonprofit advocacy organization, the Society for Women's Health Research, in 2007. The survey was designed to test women's general knowledge of cardiac risk factors. We grouped the questions into five psychosocial/knowledge categories: worry, motivation, personal cardiovascular risk awareness, general cardiac knowledge, and general cholesterol knowledge. Univariate and multivariate modeling of the relationships of these psychosocial/knowledge categories-along with five baseline demographic variables, age, ethnicity, income, education, and geographic location-to the motivation score were performed. RESULTS Univariate modeling revealed that higher motivation scores were associated with greater personal risk factor knowledge/awareness and more worry about cardiovascular disease (CVD) (R(2)=0.43, 95% confidence interval [CI] 0.35-0.50 for both scores). Younger age, Asian ethnicity, and lower education levels were associated with less motivation to modify their cardiovascular risk factors (p<0.05). Multivariate modeling revealed a persistent significant relationship of motivation to worry, personal cardiovascular risk awareness, age <45 years, and nonblack, non-Hispanic ethnic minority (p<0.001). CONCLUSIONS Worried and knowledgeable women over the age of 45 are motivated to modify their risk factors. Heart health education targeting the subgroups of less motivated women may be of benefit to raise awareness of heart disease.
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Affiliation(s)
- Erin M Galbraith
- Emory University, Department of Cardiology, Atlanta, Georgia, USA.
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Muñoz LR, Etnyre A, Adams M, Herbers S, Witte A, Horlen C, Baynton S, Estrada R, Jones ME. Awareness of heart disease among female college students. J Womens Health (Larchmt) 2010; 19:2253-9. [PMID: 20946064 DOI: 10.1089/jwh.2009.1635] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE Awareness of heart disease as the leading cause of death in women has increased over the past 10 years, but little is known about the awareness level of college students. This study evaluated the level of awareness and knowledge of heart disease in women among college students. METHODS AND RESULTS Using a cross-sectional design, a sample of 320 women from a private university was queried. A 13-item survey assessed demographic information and awareness of cardiovascular disease (CVD). The mean age was 23 years; the majority were single and of Hispanic ethnicity. Almost one third believed breast cancer was the greatest problem facing women. One half recognized CVD as the leading cause of death among women. Students aged 18-24 years were significantly less likely to identify heart disease/heart attack as the leading cause of death in women compared with students aged 25-34 years. Significant ethnic differences in perceptions of risk were found. Family history and obesity were seen as major contributors to CVD; less than a fourth ever discussed CVD with their healthcare provider. Information was gained primarily from television, magazines, and the Internet. Exercise and maintenance of healthy blood pressure were viewed as priorities in prevention of CVD. CONCLUSIONS Results add to the body of research on CVD risk and the need for intervention to increase awareness and knowledge of heart disease risk among younger and ethnically diverse young women and raises questions about the role of colleges and universities in promotion of student health. Colleges and universities may provide the last opportunity to reach youth as a group to affect lifestyle changes.
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Affiliation(s)
- Laura R Muñoz
- School of Nursing and Health Professions, University of the Incarnate Word, San Antonio, Texas 78209, USA.
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Hamner J, Wilder B. Knowledge and risk of cardiovascular disease in rural Alabama women. ACTA ACUST UNITED AC 2008; 20:333-8. [PMID: 18588661 DOI: 10.1111/j.1745-7599.2008.00326.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE The purpose of this study was to describe rural women's knowledge of cardiovascular disease (CVD) and actual risk of CVD. The research question guiding this study was: "Are there relationships between demographic factors, women's knowledge of CVD, and women's CVD risk score?" DATA SOURCES Demographic data were collected from a convenience sample of 112 women at a full-service, rural medical clinic in Alabama. Two questions assessed women's knowledge of their risk factors for CVD. The Coronary Heart Disease Knowledge Test measured knowledge of coronary heart disease (CHD). Framingham CHD prediction scores were calculated to assess the actual heart disease risk of subjects. CONCLUSIONS Knowledge of CVD in rural Alabama women is inadequate. The mean score for the knowledge test was 8.50 out of 20. This population of women has significant risk for CVD. Women recognized that smoking and obesity are issues, but are less aware of factors such as race, personality types, oral contraceptive use, hypertension, diabetes, age, hyperlipidemia, and family history. IMPLICATIONS FOR PRACTICE The majority of women in the study could list only one or two CVD risk factors. New strategies for educating women about CVD should be explored by nurse practitioners (NPs). For example, NPs interested in CVD in women could organize and offer to teach in local schools, colleges, universities, churches, and at sites where women work. Collaboration with the local American Heart Association and Health Department in educating women may be appropriate. By increasing women's knowledge, their actual risk may change and thus improve their chance to live free of CVD or have it later in life or to a lesser extent.
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Affiliation(s)
- Jenny Hamner
- School of Nursing, Auburn University, Auburn, Alabama 36849-5505, USA.
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Christian AH, Rosamond W, White AR, Mosca L. Nine-Year Trends And Racial And Ethnic Disparities in Women's Awareness of Heart Disease And Stroke: An American Heart Association National Study. J Womens Health (Larchmt) 2007; 16:68-81. [PMID: 17274739 DOI: 10.1089/jwh.2006.m072] [Citation(s) in RCA: 120] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The purpose of this study was to evaluate trends in women's awareness, knowledge, and perceptions related to cardiovascular disease (CVD) since 1997, when the American Heart Association initiated a national campaign for women. METHODS AND RESULTS A nationally representative sample of 1,005 women identified through random digit dialing (mean age 50 years, 71% white) was surveyed in 2006, and results were compared with results of similar surveys conducted in 2003, 2000, and 1997. Awareness, knowledge, and perceptions related to CVD were evaluated using a standardized interviewer-assisted questionnaire. In 2006, awareness of heart disease as the leading cause of death among women was 57%; significantly higher than in prior surveys (p < 0.001). Awareness was lower among black and Hispanic women compared with white women (31% and 29% vs. 68%, p < 0.05), and the racial/ethnic difference has not appreciably changed over time. More than twice as many women felt uninformed about stroke compared to heart disease in 2006 (23% vs. 11%, p < 0.05). Hispanic women were more likely than white women to report that there is nothing they can do to keep themselves from getting CVD (22% vs. 11%, p < 0.05). The majority of respondents (> or = 50%) reported confusion related to basic CVD prevention strategies. CONCLUSIONS CVD awareness has increased significantly among women since 1997, yet the racial/ethnic gap in awareness has not narrowed. Educational efforts to increase heart disease and stroke awareness should be targeted to racial/ethnic minorities, especially Hispanics. Methods to reinforce basic CVD prevention strategies are needed.
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Affiliation(s)
- Allison H Christian
- NewYork-Presbyterian Hospital and Division of Cardiology, Columbia University Medical Center, New York, New York 10032
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Abstract
OBJECTIVE To review the status of consultation-liaison psychiatry and the factors shaping it, and suggest strategies for its future development. METHOD In addition to searches of the main computerized psychiatric databases and review of relevant Commonwealth of Australia publications, the author drew on discussions with national and international colleagues in his role as convenor of the International Organization for Consultation-Liaison Psychiatry. RESULTS Physical/psychiatric comorbidity and somatization, the conditions in which consultation-liaison psychiatry specializes, are the commonest forms of psychiatric presentation in the community. They are as disabling as psychotic disorders, and comorbid depression in particular is a predictor of increased morbidity and mortality. Acknowledging this, the Second Australian National Mental Health Plan called for consultation-liaison psychiatry to be allowed to participate fully in the mental health care system. It stated that failure to define the term 'severe mental health problems and mental disorders' in the First Plan had led to some public mental health systems erroneously equating severity with diagnosis rather than level of need and disability. The call has been largely unheeded. The implication for patient care is both direct and indirect; the context created for psychiatry training by such a restricted focus is helping to perpetuate the neglect of such patients. This is a worldwide problem. CONCLUSIONS Proactive involvement with consumers is required if the problem is to be redressed. At a service level, development of a seamless web of pre-admission/admission/post-discharge functions is required if patients with physical/psychiatric comorbidity and somatoform disorders are to receive effective care, and consultation-liaison psychiatry services are to be able to demonstrate efficacy. Focus on comorbidity in the Australian Third National Mental Health Plan may force resolution of the current problems.
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Affiliation(s)
- Graeme C Smith
- Department of Psychological Medicine, Monash University, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia.
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Wilcox S, Ainsworth BE, LaMonte MJ, DuBose KD. Worry regarding major diseases among older African-American, Native-American, and Caucasian women. Women Health 2003; 36:83-99. [PMID: 12539794 DOI: 10.1300/j013v36n03_06] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study examined worry regarding seven major diseases and their correlates in a sample of African-American (n = 57), Native-American (n = 50), and Caucasian (n = 53) women ages 36 to 91 years. African-American and Native-American women were most worried about developing cancer (44% and 50%, respectively) while Caucasian women were most worried about osteoporosis (37%) and cancer (33%). Women from each ethnic group were more worried about developing cancer than cardiovascular diseases and conditions. African-American and Native-American women were more worried than Caucasian women about developing diabetes and high cholesterol. Body mass index (BMI) was a consistent correlate of worry: heavier women were more worried about developing diseases than were leaner women. Other risk factors (e.g., physical activity, blood pressure), however, were generally not associated with disease worry. In fact, age was inversely associated with worry regarding diabetes, cancer, and osteoporosis. Although women who were more worried about developing cancer were more likely to perform monthly breast self-exams, worry regarding other diseases was not associated with preventive actions. These results are generally consistent with other studies that indicate women are more concerned about cancer than cardiovascular diseases.
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Affiliation(s)
- Sara Wilcox
- Department of Exercise Science, Norman J. Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
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Pitsavos C, Panagiotakos DB, Chrysohoou C, Skoumas J, Papaioannou I, Stefanadis C, Toutouzas PK. The effect of Mediterranean diet on the risk of the development of acute coronary syndromes in hypercholesterolemic people: a case-control study (CARDIO2000). Coron Artery Dis 2002; 13:295-300. [PMID: 12394655 DOI: 10.1097/00019501-200208000-00008] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Hypercholesterolemia has been identified as a major risk factor for the development of coronary artery disease. The aim of this study was to assess the effect of a Mediterranean diet on the development of non-fatal acute coronary syndromes (ACS) in hypercholesterolemic people, with or without statin treatment. METHODS During 2000-2001, 848 randomly selected patients with a first event of coronary heart disease and 1078 cardiovascular disease-free people, matched to the patients by sex, age and region, were studied. Treatment of hypercholesterolemia with statin and the adoption of a Mediterranean diet were recorded. RESULTS Hypercholesterolemia was present in 534 (63%) out of 848 coronary patients and 399 (37%) out of 1078 control participants. One hundred and seventy-one (32%) of the hypercholesterolemic patients and 168 (42%) of the hypercholesterolemic control participants were treated with statins and also followed a Mediterranean diet. The analysis showed that the combination of a Mediterranean diet and statin medical therapy is associated with an additional reduction of the coronary risk (odds ratio = 0.57, P < 0.01), independently from cholesterol levels and the other cardiovascular factors. CONCLUSION The adoption of a Mediterranean diet by hypercholesterolemic people seems to reinforce the benefits from statin treatment on lipid levels and reduces the risk of developing ACS. However, it is hard to claim that our findings suggest causal evidence, and in order to explain the potential common mechanism between diet and statin treatment much remains to be learned.
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Affiliation(s)
- Christos Pitsavos
- Cardiology Department, School of Medicine, University of Athens, Greece
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Malarcher AM, Casper ML, Matson Koffman DM, Brownstein JN, Croft J, Mensah GA. Women and cardiovascular disease: addressing disparities through prevention research and a national comprehensive state-based program. JOURNAL OF WOMEN'S HEALTH & GENDER-BASED MEDICINE 2001; 10:717-24. [PMID: 11703882 DOI: 10.1089/15246090152636451] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- A M Malarcher
- Cardiovascular Health Branch, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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