Low Cardiovascular Disease Awareness in Chilean Women: Insights from the ESCI Project

Abstract

Background: Although cardiovascular disease (CVD) is the leading cause of mortality in Latin American women, limited data exist on CVD perceptions in this population. This study aimed to assess CVD awareness and knowledge of women from Santiago, Chile.

Methods: This was a cross-sectional study conducted in women 35 to 70 years old. A multistage probability sampling (stratified by age and socioeconomic level) was used for participant selection. Participants completed a home survey about knowledge of CVD, risk factors, and perceived risk (based on standardized questions from the American Heart Association awareness survey).

Results: 723 women participated in the study (mean age: 51 ± 9 years; 17.6% with high education level). Only 9.3% of the respondents mentioned CVD as women's primary health problem, whereas 22.7% and 16.1%, respectively, listed breast cancer and other cancers. When asked to identify the leading cause of women's death, only 14.4% identified CVD compared to 69.1% who recorded cancer. Older women (≥ 55 years) more likely identified CVD as the main cause of death: (OR 2.9: 95% CI = 1.8-4.5) versus younger women (<55 years). CVD family history was also associated with higher awareness of CVD as the leading cause of death (OR 1.7: 95% IC; p = 1.1-2.6). Instead, women with middle education level were less likely to mention CVD as the main women's killer.

Conclusions: Chilean women from Santiago have a low awareness of CVD as the leading cause of death and do not recognize CVD as their prominent health problem. Efforts should focus on increasing awareness and knowledge about CVD especially in young women.

Keywords: cardiovascular disease; health knowledge; risk factors; women.

Figure 1

Distribution of participants’ responses about the main health problem for women. This question was a ‘one-size-fits-all,’ meaning the interviewer asked the participant to select the most important answer if she mentioned more than one. The survey had a drop-down list of potential answers, and only one could be selected. The potential answers were not read to the participant, and the interviewer had to classify the spontaneous answer within the available choices. * Cancer includes all malignancies except those in the breast and lung. AIDS, acquired immune deficiency syndrome.

Figure 2

Perception of stress/depression, breast cancer, and cardiovascular disease as the main health problem for women, by education level. Participants were asked for the years of formal education and the highest qualification received. Three education levels were defined: low (primary school or less; 0–8 years), middle (complete or incomplete secondary education; 9–12 years), and high (complete or incomplete university or technical studies; >12 years). * p < 0.01 high vs middle and low education levels. † p < 0.01 middle vs high education level.

Figure 3

Distribution of participants’ responses about leading cause of death in women. This question was a ‘one-size-fits-all,’ meaning the interviewer asked the participant to select the most important answer if she mentioned more than one. The survey had a drop-down list of potential answers, and only one could be selected. The potential answers were not read to the participant, and the interviewer had to classify the spontaneous answer within the available choices. * Cancer includes all malignancies except those in the breast and lung. AIDS, acquired immune deficiency syndrome.

Figure 4

Distribution of participants’ responses about knowledge of heart disease (A) and stroke (B) in women.

Figure 5

Perceived leading cause of death vs actual mortality data from national statistics in Chile (2016). Data from national statistics are derived from National Institute of Statistics (INE): mortality in women ≥35 years by all causes [12]. Survey respondents are the 723 women who participated in the current study. * All cancer includes all malignancies except those in the breast and lung.