Gender and Social Inequalities in Awareness of Coronary Artery Disease in European Countries

Abstract

Coronary artery disease (CAD) is the single leading cause of death in Europe and the most common form of cardiovascular disease. Little is known about awareness in the European population. A cross-sectional telephone survey of 2609 individuals from six European countries was conducted to gather information on perceptions of CAD, risk factors, preventive measures, knowledge of heart attack symptoms and ability to seek emergency medical care. Level of awareness was compared according to gender, age, socioeconomic status (SES) and educational level. Women were approximately five times less likely than men to consider heart disease as a main health issue or leading cause of death (OR = 0.224, 95% CI: 0.178-0.280, OR = 0.196, 95% CI: 0.171-0.226). Additionally, women were significantly less likely to have ever had a cardiovascular screening test (OR = 0.515, 95% CI: 0.459-0.578). Only 16.3% of men and 15.3% of women were able to spontaneously identify the main symptoms of a heart attack. Almost half of the sample failed to state that they would call emergency services in case of a cardiac event. Significant differences according to age, SES and education were found for many indicators amongst both men and women. Development of a European strategy targeting improved awareness of CAD and reduced gender and social inequalities within the European population is warranted.

Keywords: Europe; awareness; coronary artery disease; gender bias; inequalities; sex differences.

Figure 1

Odds Ratios and 95% CIs pertaining to selected indicators of awareness. Gender odds ratios and associated 95% CIs adjusted for age, SES, education and prior experience of a heart attack (males provide reference group), with the exception of variable 7 which is adjusted for age, SES and education. Dashed line is OR = 1, i.e., no gender difference. Weighted data. (1) Heart diseases is a main health issue for your gender; (2) Heart diseases is a leading cause of death for your gender; (3) Would call emergency services when suffering a heart attack; (4) Would call emergency services if somebody else suffered a heart attack; (5) Knows main warning signs of a heart attack; (6) Has taken a cardiovascular screening test ever; (7) Has suffered a heart attack; (8) Doctor has discussed risk factors; (9) Would like more information on heart disease; (10) I am informed about heart disease and the risk factors associated with it; (11) Knows what to do and how to do it, when it comes to preventing heart disease. p < 0.05 for variables 1–4, 6–8 and 11.