title: Cardiovascular secondary prevention: patients' knowledge of cardiovascular risk factors and their attitude to reduce the risk burden, and the practice of family doctors. The "Help Your Heart Stay Young" study.
abstract: BACKGROUND
  Whether the practice of family doctors of assessing the global cardiovascular risk profile improves the knowledge of cardiovascular risk factors and the attitude to lifestyle change in patients' secondary cardiovascular prevention is unknown.
  
  
  METHODS
  We evaluated subjects who visited their family doctors and those with self-reported cardiovascular disease in the urban area of Naples, Italy. Patients self-administered a simple standard questionnaire to evaluate their knowledge of cardiovascular risk factors and of simple lifestyle modifications to reduce the cardiovascular risk burden. For each participant, family doctors, blinded to the information provided by patients, had to provide a global coronary risk based on the risk factors recorded in their electronic database, or report the missing information.
  
  
  RESULTS
  The study sample comprised 560 subjects, 61% male, with mean age 60 +/- 9 years. Angina pectoris (49%) and myocardial infarction (40.9%) were the most frequently self-reported cardiovascular diseases in the study sample. The self-reported data revealed that 46% of the sample was overweight and an additional 20% overtly obese. Among those who self-reported arterial hypertension, approximately 11% admitted that they were unaware of their blood pressure, and 26% believed that they were normotensive but reported a recently detected blood pressure > 140/90 mmHg. Approximately 8% were not aware of whether they had high cholesterol levels, and among those who declared having normal cholesterol levels, 9% referred levels > 200 mg/dl. Of the sample, 22% self-reported diabetes, but 7% did not know whether they were diabetic or not. Thirty percent of the sample were smokers and among these, 40% smoked > 20 cigarettes/day. A low level of education was reported in 66% of the study sample. Women were more frequently obese, more often reported high cholesterol levels, had a low level of education and achieved a lower score from the questionnaire on knowledge of cardiovascular risk factors than men. Patients > 55 years more often reported an elevated blood pressure among those who defined themselves as normotensive, and achieved a lower score from the questionnaire on knowledge of cardiovascular risk factors than younger patients.
  
  
  CONCLUSIONS
  With regard to secondary cardiovascular prevention, the study population was found to have insufficient knowledge of cardiovascular risk factors and of the correct approach to reduce their global risk despite the fact that the attitude of their family doctors in detecting and recording risk factors was above average.
authors.affiliation: Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy. aldo.celentano@unina.it
authors.forename: Aldo
authors.initials: A
authors.lastname: Celentano
authors.forename: Vittorio
authors.initials: V
authors.lastname: Palmieri
authors.forename: Emma
authors.initials: E
authors.lastname: Arezzi
authors.forename: Maria
authors.initials: M
authors.lastname: Sabatella
authors.forename: Bruno
authors.initials: B
authors.lastname: Guillaro
authors.forename: Ciro
authors.initials: C
authors.lastname: Brancati
authors.forename: Gaetano
authors.initials: G
authors.lastname: Piccinocchi
authors.forename: Stefana
authors.initials: S
authors.lastname: Minichiello
authors.forename: Cesare
authors.initials: C
authors.lastname: Russo
authors.forename: Salvatore
authors.initials: S
authors.lastname: Pezzullo
authors.forename: Antonella
authors.initials: A
authors.lastname: Tufano
authors.forename: Luigi
authors.initials: L
authors.lastname: Finelli
authors.forename: Salvatore
authors.initials: S
authors.lastname: Panico
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Minno
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000503:physiopathology / Q000517:prevention & control*; D015331:Cohort Studies; D005194:Family Practice; D005260:Female; D015438:Health Behavior; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D055502:Secondary Prevention