Waśniowska Anna, Kozela Magdalena, Podolec Piotr, Pająk Andrzej
Department of Diagnostics, John Paul II Hospital, Krakow, Poland.
Kardiol Pol. 2017;75(4):386-394. doi: 10.5603/KP.a2016.0180. Epub 2016 Dec 20.
Providing knowledge of cardiovascular disease (CVD) risk factors is the main component of prevention pro-grammes, which aim to reduce the exposure to these factors and decrease CVD incidence and mortality. However, evidence linking knowledge of CVD risk factors and the risk of death is scarce.
The aim of the study was to assess the relation between knowledge of CVD risk factors and the risk of death from all causes in middle-aged residents of Krakow and to assess whether this relation depends on the level of education.
The study sample included 1756 men and 1788 women selected from a population of Krakow residents at age 45-64 years. Knowledge of CVD risk factors was assessed for every risk factor separately using a standard questionnaire. Results were summarised by calculating the "knowledge index" (from -15 to 15 points). Information on deaths was obtained from the registry of Krakow residents. Cox proportional hazards model was used to assess the relation between knowledge of CVD risk factors and all-cause mortality.
At baseline examination the participation rate was 66% in men and 65% in women. The proportion of participants with secondary or higher education was 61% in men and 66% in women. Distribution of knowledge index was right skewed, and the median was 11 (interquartile range: 9-13) in both sexes. Median time of follow-up was 14.35 years (interquartile range: 14.30-14.39). There were 307 deaths in men and in women. Men with a low level of knowledge of risk factors had a higher risk of death. However, adjustment for education attenuated the association. After stratification by the level of education, in men with secondary education or higher, an inverse relation between the knowledge of CVD risk factors and the risk of death was found. In this group, men with a low level of knowledge of CVD risk factors had about a 60% higher risk of death, compared to men with high knowledge. In men with low education and in women the risk of death was not associated with knowledge of risk factors.
In a Krakow population characterised by a high proportion of residents with secondary or higher education, the association between knowledge of CVD risk factors and the risk of death depended on sex and the level of education. A lower level of knowledge of risk factors was associated with a higher risk of death only in men with secondary or higher education.
提供心血管疾病（CVD）危险因素的知识是预防计划的主要组成部分，这些计划旨在减少对这些因素的暴露，并降低CVD的发病率和死亡率。然而，将CVD危险因素知识与死亡风险联系起来的证据很少。
本研究的目的是评估克拉科夫中年居民对CVD危险因素的知识与全因死亡风险之间的关系，并评估这种关系是否取决于教育水平。
研究样本包括从克拉科夫45-64岁居民中选取的1756名男性和1788名女性。使用标准问卷分别对每个危险因素的CVD危险因素知识进行评估。通过计算“知识指数”（从-15到15分）来总结结果。死亡信息来自克拉科夫居民登记处。采用Cox比例风险模型评估CVD危险因素知识与全因死亡率之间的关系。
在基线检查时，男性的参与率为66%，女性为65%。具有中等或高等教育程度的参与者比例男性为61%，女性为66%。知识指数分布呈右偏态，两性的中位数均为11（四分位间距：9-13）。中位随访时间为14.35年（四分位间距：14.30-14.39）。男性和女性共有307人死亡。危险因素知识水平低的男性死亡风险更高。然而，对教育程度进行调整后减弱了这种关联。按教育程度分层后，在具有中等或高等教育程度的男性中，发现CVD危险因素知识与死亡风险之间存在负相关。在这一组中，CVD危险因素知识水平低的男性与知识水平高的男性相比，死亡风险高出约60%。在低教育程度的男性和女性中，死亡风险与危险因素知识无关。
在以中等或高等教育程度居民比例高为特征的克拉科夫人群中，CVD危险因素知识与死亡风险之间的关联取决于性别和教育水平。仅在具有中等或高等教育程度的男性中，较低的危险因素知识水平与较高的死亡风险相关。
