title: Knowledge of modifiable risk factors of heart disease among patients with acute myocardial infarction in Karachi, Pakistan: a cross sectional study.
abstract: BACKGROUND
  Knowledge is an important pre-requisite for implementing both primary as well as secondary preventive strategies for cardiovascular disease (CVD). There are no estimates of the level of knowledge of risk factor of heart disease in patients with CVD. We estimated the level of knowledge of modifiable risk factors and determined the factors associated with good level of knowledge among patients presenting with their first acute myocardial infarction (AMI) in a tertiary care hospital in Karachi, Pakistan.
  
  
  METHODS
  A hospital based cross-sectional study was conducted at the National Institute of Cardiovascular Disease, a major tertiary care hospital in Karachi Pakistan. Patients admitted with their first AMI were eligible to participate. Standard questionnaire was used to interview 720 subjects. Knowledge of four modifiable risk factors of heart disease: fatty food consumption, smoking, obesity and exercise were assessed. The participants knowing three out of four risk factors were regarded as having a good level of knowledge. A multiple logistic regression model was constructed to identify the determinants of good level of knowledge.
  
  
  RESULTS
  The mean age (SD) was 54 (11.66) years. A mere 42% of our study population had a good level of knowledge. In multiple logistic regression analysis, independent predictors of "good" level of knowledge were (odds ratio [95% confidence interval]) more than ten years of schooling were 2.5 [1.30, 4.80] (verses no schooling at all) and nuclear family system (verses extended family system) 2.54 [1.65, 3.89]. In addition, Sindhi ethnicity OR [3.03], higher level of exercise OR [2.76] and non user of tobacco OR [2.53] were also predictors of good level of knowledge.
  
  
  CONCLUSIONS
  Our findings highlight the lack of good level of knowledge of modifiable risk factors for heart disease among subjects admitted with AMI in Pakistan. There is urgent need for aggressive and targeted educational strategies in the Pakistani population.
authors.affiliation: Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan. epidemiologist@gmail.com
authors.forename: Muhammad S
authors.initials: MS
authors.lastname: Khan
authors.forename: Fahim H
authors.initials: FH
authors.lastname: Jafary
authors.forename: Tazeen H
authors.initials: TH
authors.lastname: Jafar
authors.forename: Azhar M
authors.initials: AM
authors.lastname: Faruqui
authors.forename: Syed I
authors.initials: SI
authors.lastname: Rasool
authors.forename: Juanita
authors.initials: J
authors.lastname: Hatcher
authors.forename: Nish
authors.initials: N
authors.lastname: Chaturvedi
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006331:Heart Diseases / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction; D010154:Pakistan; D012307:Risk Factors; D011795:Surveys and Questionnaires