Women's Cardiovascular Program, Division of Cardiology, Center for Women's Health, Columbia University, 622 West 168th Street, New York, NY 10032, USA.
J Womens Health (Larchmt). 2011 Jun;20(6):893-900. doi: 10.1089/jwh.2010.2448. Epub 2011 Apr 14.
Abstract Background: The diversity of the U.S. population and disparities in the burden of cardiovascular disease (CVD) require that public health education strategies must target women and racial/ethnic minority groups to reduce their CVD risk factors, particularly in high-risk communities, such as women with the metabolic syndrome (MS).
The data reported here were based on a cross-sectional face-to-face survey of women recruited from four participating sites as part of the national intervention program, Improving, Enhancing and Evaluating Outcomes of Comprehensive Heart Care in High-Risk Women. Measures included baseline characteristics, sociodemographics, CVD related-knowledge and awareness, and Framingham risk score (FRS).
There were 443 of 698 women (63.5%) with one or more risk factors for the MS: non-Hispanic white (NHW), 51.5%; non-Hispanic black (NHB), 21.0%; Hispanic, 22.6%. Greater frequencies of MS occurred among Hispanic women (p<0.0001), those with less than a high school education (70.0%) (p<0.0001), Medicaid recipients (57.8%) (p<0.0001), and urbanites (43.3%) (p<0.001). Fewer participants with MS (62.6%) knew the leading cause of death compared to those without MS (72.1%) (p<0.0001). MS was associated with a lack of knowledge of the composite of knowing the symptoms of a heart attack plus the need to call 911 (odds ratio [OR] 0.41, 95% confidence interval [CI] 0.17-0.97, p=0.04).
Current strategies to decrease CVD risk are built on educating the public about traditional factors, including hypertension, smoking, and elevated low-density lipoprotein cholesterol (LDL-C). An opportunity to broaden the scope for risk reduction among women with cardiometabolic risk derives from the observation that women with the MS have lower knowledge about CVD as the leading cause of death, the symptoms of a heart attack, and the ideal option for managing a CVD emergency.
美国人口的多样性和心血管疾病(CVD)负担的差异要求公共卫生教育策略必须针对妇女和种族/少数民族群体,以降低她们的 CVD 风险因素,特别是在高危社区,如患有代谢综合征(MS)的妇女。
这里报告的数据是基于从四个参与地点招募的妇女的一项横断面面对面调查,作为国家干预计划的一部分,改善、增强和评估高危妇女综合心脏护理的结果。措施包括基线特征、社会人口统计学、CVD 相关知识和意识以及弗雷明汉风险评分(FRS)。
在 698 名妇女中有 443 名(63.5%)有一个或多个 MS 风险因素:非西班牙裔白人(NHW),51.5%;非西班牙裔黑人(NHB),21.0%;西班牙裔,22.6%。西班牙裔妇女中 MS 发生的频率更高(p<0.0001),受教育程度较低(70.0%)(p<0.0001),医疗补助受助人(57.8%)(p<0.0001),城市居民(43.3%)(p<0.001)。更多患有 MS 的参与者(62.6%)不知道导致死亡的主要原因,而没有 MS 的参与者(72.1%)(p<0.0001)。MS 与缺乏对心脏病发作症状的了解加上需要拨打 911 的综合知识有关(比值比 [OR] 0.41,95%置信区间 [CI] 0.17-0.97,p=0.04)。
目前降低 CVD 风险的策略是建立在教育公众了解传统因素的基础上,包括高血压、吸烟和升高的低密度脂蛋白胆固醇(LDL-C)。有机会扩大患有心脏代谢风险的妇女的风险降低范围,这是因为观察到患有 MS 的妇女对 CVD 作为主要死亡原因、心脏病发作症状以及管理 CVD 紧急情况的理想选择的了解程度较低。