What is killing? People’s knowledge about coronary heart disease, attitude towards prevention and main risk reduction barriers in Ismailia, Egypt (Descriptive cross sectional study)
Cardiovascular diseases are public health concern everywhere, especially ischemic or coronary heart diseases (CHD) which are on top of causes list of mortality and morbidity in both genders globally. From which nearly 80% can be due to modifiable risk factors. In Egypt, there is lack of studies concerning the knowledge of people about coronary heart diseases and its modifiable risk factors. So, this research reported here is designed to measure the dimensions of people knowledge about CHD and their attitude towards prevention, and to identify the main risk reduction barriers.
By using comprehensive cross-sectional, descriptive research design methodology, all adult individuals attending family health clinic at Suez Canal University Hospital were eligible for inclusion with total number 125 participants. An interview questionnaire was designed to collect data.
the study revealed that (10.4%) of participants had a history of CHD, and (7.2%) had a family history of CHD. 79.2% had satisfactory total level of knowledge about CHD, and (94.4%) had a positive total attitude towards prevention. Risk reduction barriers were recognized as medical setting barrier (24%), patient related barrier (22.4%), and community and societal was almost the same as knowledge barrier, around (16%) and the least was the systemic and organizational barrier which considered being (9.6%).
It is concluded that the level of total knowledge about CHD was satisfactory, but lower than the level total of attitude. More effort is needed by the health system to improve the settings and engage patients in their plans and breaking related barriers, with development of structured health education programs based on needs assessment. Further studies are needed to investigate the reasons and follow up the process for changes.
Non-communicable, coronary heart disease, knowledge, attitude, risk, barriers, Egypt, morbidity, morbidity, Public health
Cardiovascular diseases are public health concern everywhere, especially ischemic or coronary heart diseases (CHD) which are on top of causes list of mortality and morbidity in both genders globally (1). CHDs are greatly increased issues, and are the major causes of illness and deaths in the Middle East Region, responsible for 21% of deaths, from which nearly 80% can be due to modifiable risk factors (2).
Globally and within the region the sedentary life, high fat diet, high blood pressure, smoking, diabetes, obesity, dyslipidaemia and stress are the main risk factors leading to increased prevalence of CHD and especially in Egypt (2). The World health organization data have shown that, CHD is responsible for 10% of Disability-adjusted life years (DALY) lost in low- and middle-income countries. In Egypt it is responsible for 21% of fatality and 13 % of DALY (3).
The region countries are suffering from a tow fold burden, from both infectious and non-infectious diseases, where shortly the non-infectious diseases will be the most. And as shown from data that CHD will impose the highest with in the cardiovascular diseases and the countries burden of disease in men and women (4), (5). It is now an emerging major health problem in low and middle income countries. The incidence curve of CHD, among Egyptians, is rising in the last few decades. This is a general impression among Egyptian physicians repeatedly discussed in scientific meetings.
CHD mortality is affected by presence of the different risk factors especially high blood pressure, cholesterol level, smoking, physical inactivity , stress and diet , where up to 90% of mortality cases have one or more risk factors that are affected by people living style (4),(6).
Where in Egypt the major risk factor prevalence are as the following, the smoking prevalence is nearly 48% for men and 4% for women, the prevalence of hypertension is almost 31% (7), the prevalence of DM is 7.8% in urban areas, 5.6% in rural agricultural areas, and 2.5% in rural desert areas and the prevalence of obesity is 55.6 % (8).
And where is a relatively long time between exposure to a risk factor and development of disease, consequently there is a need to focus efforts on the risk factors that predict disease and the distribution of these risk factors within the population is the corner stone required for planning of prevention.
Preventive strategies are needed to focus on the population as a whole, and more specifically on the people at high risk of certain diseases. Prevention can be done but it is usually missed, and where more than half of deaths due to CHD occurred outside the health facilities, the role of primary prevention is increasing and risk factor identification and barriers to risk reduction is getting more valuable (7). Starting a healthy living style by stop smoking, losing weight and starting to be active is the base for prevention and treatment of heart disease (9).
Men, as well as women should be made more aware of their own risk of developing CHD and of the manifestations of CHD. Physicians should be encouraged to ask patients more deeply and comprehensively about their illnesses understanding, beliefs, and attitudes to check their knowledge (10), and define the barriers to risk reduction.
In Egypt, there is lack of studies concerning the knowledge of people about coronary heart diseases and its modifiable risk factors. So, this research reported here is designed to measure the dimensions of people knowledge about CHD and their attitude towards prevention, and to identify the main risk reduction barriers. It is hoped that this study will contribute to our knowledge in this field to put understand to the risk factors that we can prevent and control , and the current picture as a step for prevention and breaking down the barriers.
This study aims to identify People’s knowledge about coronary heart disease, their attitude towards prevention and main risk reduction barriers. This was to be achieved through measuring their knowledge and attitude towards CHD, its risk factors and identification of the main barriers for achieving risk reduction.