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Predictors of Heart Disease Knowledge Among Older and Younger Asian Indian Adults

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Abstract

Coronary heart disease (CHD) has been estimated to be the leading cause of mortality in developing countries in 2010, particularly among Asian Indians. When compared to other populations globally, Asian Indians less than 40 years of age are at an increased risk of myocardial infarction. The objective of this study was to identify the predictors of knowledge of heart disease among younger and older Asian Indians adults. A cross-sectional survey was undertaken in Sydney Australia. One hundred and forty-four participants of Asian Indian descent who attended the health promotion stall at the Australia India Friendship Fair in Sydney participated in the study. All participants completed a self-administered questionnaire. The Primary outcome of the survey was knowledge of heart disease as measured by the 25 item Heart Disease Facts Questionnaire. All six modifiable risk factors for heart disease namely smoking, high blood pressure, diabetes, high cholesterol, physical inactivity and overweight were identified by 45.2 % of those aged below 40 and 53.5 % of those aged above 40 years of age respectively. For younger adults, only smoking status was significant and was an independently predictor of knowledge related to CHD (b = −10.6, p = 0.001, sr2 = 0.16). For older adults, smoking status and duration of residence were significant predictors of knowledge related to CHD (b = −7.4, p = 0.000, sr2 = 0.24; b = 0.13, p = 0.001, sr2 = 0.069 respectively). Although suboptimal, there were no statistically significant differences in the level of knowledge among older and younger Asian Indians. Nevertheless, strategies to improve the knowledge of heart disease among this cohort are warranted.

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References

  1. World health rankings: Live Longer Liver Better. http://www.worldlifeexpectancy.com/cause-of-death/coronary-heart-disease/by-country/. 2014.

  2. Lozano R, Naghavi M, Foreman K, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2013;380(9859):2095–128.

    Article  Google Scholar 

  3. Harding S, Rosato M, Teyhan A. Trends for coronary heart disease and stroke mortality among migrants in England and Wales, 1979–2003: slow declines notable for some groups. Heart. 2008;94(4):463–70.

    Article  CAS  PubMed  Google Scholar 

  4. McKeigue PM, Miller G, Marmot M. Coronary heart disease in south Asians overseas: a review. J Clin Epidemiol. 1989;42(7):597–609.

    Article  CAS  PubMed  Google Scholar 

  5. Palaniappan L, Wang Y, Fortmann SP. Coronary heart disease mortality for six ethnic groups in California, 1990–2000. Ann Epidemiol. 2004;14(7):499–506.

    Article  PubMed  Google Scholar 

  6. Anand SS, Yusuf S, Vuksan V, et al. Differences in risk factors, atherosclerosis, and cardiovascular disease between ethnic groups in Canada: the Study of Health Assessment and Risk in Ethnic groups (SHARE). Lancet. 2000;356(9226):279–84.

    Article  CAS  PubMed  Google Scholar 

  7. Sheth T, Nair C, Nargundkar M, Anand S, Yusuf S. Cardiovascular and cancer mortality among Canadians of European, south Asian and Chinese origin from 1979 to 1993 an analysis of 1.2 million deaths. Can Med Assoc J. 1999;161(2):132–8.

    CAS  Google Scholar 

  8. Hughes K, Lun K, Yeo P. Cardiovascular diseases in Chinese, Malays, and Indians in Singapore. I. Differences in mortality. J Epidemiol Commun Health. 1990;44(1):24–8.

    Article  CAS  Google Scholar 

  9. Mak K-H, Chia K-S, Kark J, et al. Ethnic differences in acute myocardial infarction in Singapore. Eur Heart J. 2003;24(2):151–60.

    Article  PubMed  Google Scholar 

  10. Magliano DJ, Söderberg S, Zimmet PZ, et al. Mortality, all-cause and cardiovascular disease, over 15 years in multiethnic Mauritius impact of diabetes and intermediate forms of glucose tolerance. Diabetes Care. 2010;33(9):1983–9.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Tuomilehto J, Li N, Dowse G, et al. The prevalence of coronary heart disease in the multiethnic and high diabetes prevalence population of Mauritius. J Intern Med. 1993;233(2):187–94.

    Article  CAS  PubMed  Google Scholar 

  12. Derry C, Bourne D, Sayed A, et al. Variations in mortality of the coloured, white and Asian population groups in the RSA, 1978–1982. Part VI. Ischaemic heart disease. S Afr Med J. 1987;72(10):698–700.

    CAS  PubMed  Google Scholar 

  13. Miller GJ, Beckles GL, Maude GH, et al. Ethnicity and other characteristics predictive of coronary heart disease in a developing community: principal results of the St James Survey, Trinidad. Int J Epidemiol. 1989;18(4):808–17.

    Article  CAS  PubMed  Google Scholar 

  14. Sharma M, Ganguly NK. Premature coronary artery disease in Indians and its associated risk factors. Vasc Health Risk Manag. 2005;1(3):217.

    PubMed  PubMed Central  Google Scholar 

  15. Yusuf S, Hawken S, Ôunpuu S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case–control study. Lancet. 2004;364(9438):937–52.

    Article  PubMed  Google Scholar 

  16. Blumstein T, Benyamini Y, Boyko V, Lerner-Geva L. Women’s knowledge about heart disease: differences among ethnic and cultural groups in the Israeli Women’s Health in Midlife Study. Women Health. 2016;56(1):78–97.

    Article  PubMed  Google Scholar 

  17. McDonnell LA, Pipe AL, Westcott C, et al. Perceived vs actual knowledge and risk of heart disease in women: findings from a Canadian survey on heart health awareness, attitudes, and lifestyle. Can J Cardiol. 2014;30(7):827–34.

    Article  PubMed  Google Scholar 

  18. Awad A, Al-Nafisi H. Public knowledge of cardiovascular disease and its risk factors in Kuwait: a cross-sectional survey. BMC Public Health. 2014;14(1):1131.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Mukattash T, Shara M, Jarab A, Al-Azzam S, Almaaytah A, Al Hamarneh Y. Public knowledge and awareness of cardiovascular disease and its risk factors: a cross-sectional study of 1000 Jordanians. Int J Pharm Pract. 2012;20:367–76.

    Article  PubMed  Google Scholar 

  20. Winham DM, Jones KM. Knowledge of young African American adults about heart disease: a cross-sectional survey. BMC Public Health. 2011;11(1):248.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Khan M, Jafary F, Jafar T, et al. Knowledge of modifiable risk factors of heart disease among patients with acute myocardial infarction in Karachi, Pakistan: a cross sectional study. BMC Cardiovasc Dis. 2006;6(1):18.

    Article  Google Scholar 

  22. Jafary F, Aslam F, Mahmud H, et al. Cardiovascular health knowledge and behavior in patient attendants at four tertiary care hospitals in Pakistan—a cause for concern. BMC Public Health. 2005;5:124.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Fernandez R, Davidson PM, Miranda C, Everett B, Salamonson Y. Attribution of risk for coronary heart disease in a vulnerable immigrant population: a survey study. J Cardiovasc Nurs. 2014;29(1):48–54.

    Article  PubMed  Google Scholar 

  24. Kandula NR, Tirodkar MA, Lauderdale DS, Khurana NR, Makoul G, Baker DW. Knowledge gaps and misconceptions about coronary heart disease among U.S. South Asians. Am J Prev Med. 2010;38(4):439–42.

    Article  PubMed  PubMed Central  Google Scholar 

  25. NSW Department of Health. New South Wales height, weight and waist circumference module training manual. 2007. http://www.health.nsw.gov.au/surveys/other/Documents/training-manual-height.pdf.

  26. Wagner J, Lacey K, Chyun D, Abbott G. Development of a questionnaire to measure heart disease risk knowledge in people with diabetes: the Heart Disease Fact Questionnaire. Patient Educ Couns. 2005;58(1):82–7.

    Article  PubMed  Google Scholar 

  27. Vaidya A, Aryal UR, Krettek A. Cardiovascular health knowledge, attitude and practice/behaviour in an urbanising community of Nepal: a population-based cross-sectional study from Jhaukhel-Duwakot Health Demographic Surveillance Site. BMJ Open. 2013;3(10):e002976.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Al Hamarneh YN, Crealey GE, McElnay JC. Coronary heart disease: health knowledge and behaviour. Int J Clin Pharm. 2011;33(1):111–23.

    Article  PubMed  Google Scholar 

  29. Avis NE, McKinlay JB, Smith KW. Is cardiovascular risk factor knowledge sufficient to influence behavior? Am J Prevent Med. 1990;6(3):137–44.

    Google Scholar 

  30. Carter-Pokras OD, Feldman RH, Kanamori M, et al. Barriers and facilitators to smoking cessation among Latino adults. J Nat Med Assoc. 2011;103(5):423–31.

    Article  Google Scholar 

  31. Zhang JY, Chan SS, Fong DY, Malone RE, Lam TH. The social context of smoking cessation in China: an exploratory interview study. Tob Control. 2012. doi:10.1136/tc.2010.040691.

    Article  CAS  PubMed  Google Scholar 

  32. Echeverría SE, Gundersen DA, Manderski MT, Delnevo CD. Social norms and its correlates as a pathway to smoking among young Latino adults. Soc Sci Med. 2015;124:187–95.

    Article  PubMed  Google Scholar 

  33. Rhodes SD, Foley KL, Zometa CS, Bloom FR. Lay health advisor interventions among Hispanics/Latinos: a qualitative systematic review. Am J Prev Med. 2007;33(5):418–27.

    Article  PubMed  Google Scholar 

  34. Wu P, Wilson K, Dimoulas P, Mills EJ. Effectiveness of smoking cessation therapies: a systematic review and meta-analysis. BMC Public Health. 2006;6(1):300.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Eisenberg MJ, Filion KB, Yavin D, et al. Pharmacotherapies for smoking cessation: a meta-analysis of randomized controlled trials. Can Med Assoc J. 2008;179(2):135–44.

    Article  Google Scholar 

  36. Lichtenstein E, Glasgow R, Lando H, Ossip-Klein D, Boles S. Telephone counseling for smoking cessation: rationales and meta-analytic review of evidence. Health Educ Res. 1996;11(2):243–57.

    Article  CAS  PubMed  Google Scholar 

  37. Myung S-K, McDonnell DD, Kazinets G, Seo HG, Moskowitz JM. Effects of Web-and computer-based smoking cessation programs: meta-analysis of randomized controlled trials. Arch Intern Med. 2009;169(10):929–37.

    Article  PubMed  Google Scholar 

  38. Liem SS, Oemrawsingh PV, Cannegieter SC, et al. Cardiovascular risk in young apparently healthy descendents from Asian Indian migrants in the Netherlands: the SHIVA study. Neth Heart J. 2009;17(4):155–61.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Khan MS, Jafary FH, Jafar TH, et al. Knowledge of modifiable risk factors of heart disease among patients with acute myocardial infarction in Karachi, Pakistan: a cross sectional study. BMC Cardiovasc Dis. 2006;6:18.

    Article  Google Scholar 

  40. O’Brien F, O’Donnell S, McKee G, Mooney M, Moser D. Knowledge, attitudes, and beliefs about acute coronary syndrome in patients diagnosed with ACS: an Irish cross-sectional study. Eur J Cardiovasc Nurs. 2013;12(2):201–8.

    Article  PubMed  Google Scholar 

  41. Ngian G-S, Sahhar J, Proudman SM, Stevens W, Wicks IP, Van Doornum S. Prevalence of coronary heart disease and cardiovascular risk factors in a national cross-sectional cohort study of systemic sclerosis. Ann Rheum Dis. 2012;71(12):1980–3.

    Article  PubMed  Google Scholar 

  42. Koya DL, Egede LE. Association between length of residence and cardiovascular disease risk factors among an ethnically diverse group of United States immigrants. J Gen Intern Med. 2007;22(6):841–6.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Mooteri SN, Petersen F, Dagubati R, Pai RG. Duration of residence in the United States as a new risk factor for coronary artery disease (The Konkani Heart Study). Am J Cardiol. 2004;93(3):359–61.

    Article  PubMed  Google Scholar 

  44. James PA, Oparil S, Carter BL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). J Am Med Assoc. 2014;311(5):507–20.

    Article  CAS  Google Scholar 

  45. Montalescot G, Sechtem U, Achenbach S, et al. 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J. 2013;34(38):2949–3003.

    Article  PubMed  Google Scholar 

  46. Ray KK, Kastelein JJ, Boekholdt SM, et al. The ACC/AHA 2013 guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease risk in adults: the good the bad and the uncertain: a comparison with ESC/EAS guidelines for the management of dyslipidaemias 2011. Eur Heart J. 2014;35(15):960–8.

    Article  PubMed  Google Scholar 

  47. Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K. Low health literacy and health outcomes: an updated systematic review. Ann Intern Med. 2011;155(2):97–107.

    Article  PubMed  Google Scholar 

  48. Wadden TA, Butryn ML, Hong PS, Tsai AG. Behavioral treatment of obesity in patients encountered in primary care settings: a systematic review. J Am Med Assoc. 2014;312(17):1779–91.

    Article  CAS  Google Scholar 

  49. Stephens J, Allen J. Mobile phone interventions to increase physical activity and reduce weight: a systematic review. J Cardiovasc Nurs. 2013;28(4):320.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Free C, Phillips G, Galli L, et al. The effectiveness of mobile-health technology-based health behaviour change or disease management interventions for health care consumers: a systematic review. PLoS Med. 2013;10(1):e1001362.

    Article  PubMed  PubMed Central  Google Scholar 

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Author Contribution

Ritin S. Fernandez: Development of research project, research proposal, ethics application, data collection, contribution to writing the paper; Bronwyn Everett: Development of research project, data collection, Recoding dataset, development of publication; Subbaram Sundar: Development of research project, research proposal, data collection, development of publication. All authors have reviewed the submitted document and approve the manuscript submission.

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Authors and Affiliations

  1. School of Nursing, University of Wollongong, Northfields Avenue, Wollongong, NSW, 2520, Australia

    Ritin S. Fernandez

  2. Centre for Research in Nursing and Health, St George Hospital, Kogarah, NSW, Australia

    Ritin S. Fernandez

  3. Centre for Applied Nursing Research, School of Nursing and Midwifery, University of Western Sydney, Parramatta, NSW, Australia

    Bronwyn Everett

  4. Ingham Institute, South Western Sydney Local Health District, Sydney, NSW, Australia

    Bronwyn Everett

  5. Toongabbie, NSW, Australia

    Subbaram Sundar

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  1. Ritin S. Fernandez
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Correspondence to Ritin S. Fernandez.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Fernandez, R.S., Everett, B. & Sundar, S. Predictors of Heart Disease Knowledge Among Older and Younger Asian Indian Adults. J Immigrant Minority Health 18, 1378–1385 (2016). https://doi.org/10.1007/s10903-016-0437-8

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  • DOI: https://doi.org/10.1007/s10903-016-0437-8

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