People who have already had one heart attack could die from a second because they know so little about the disease, a joint Australian–US study has shown.

The first large-scale international study to assess the knowledge of heart patients about their disease revealed poor levels of knowledge about symptoms and what to do when experiencing symptoms. High-risk cardiac patients also have inaccurate perceptions of their future risk of a heart attack.

Forty-six per cent of patients had "low knowledge levels" and 43 per cent thought they were at no higher risk of having another heart attack than other people their age, Professor Sharon McKinley from University of Technology Sydney (UTS) Nursing, Midwifery and Health (NM&H) and Professor Kathleen Dracup, Dean of the School of Nursing at the University of California, San Francisco (UCSF) reported to the American Heart Association.

"Our research shows that people who have had a previous heart attack do not go to hospital any earlier than people who have never had one", Professor McKinley said. "But if treated in the first hour, survival rates rise. Modern diagnosis and treatment begins in the ambulance with an ECG that is faxed to the emergency room. Doctors can decide before the patient arrives whether to send the patient straight to the cardiology department for an angiogram or whether they need to use drugs to break down a blood clot."

Unexpectedly, women in the study knew more than men about acute coronary symptoms and saw themselves at higher risk than age-matched healthy controls.

"This was unexpected because in previous studies, women have often underestimated their risk for heart disease and had longer pre-hospital delays than men", Professor McKinley said.

Researchers have presumed this indicated women's lack of knowledge of symptoms and a lack of understanding of the importance of heart disease as a cause of death in women.
 

The apparent lack of awareness among women about their heart disease risks has prompted a targeted campaign Go Red for Women. UTS enthusiastically supported the recent local inaugural Go Red for Women event. A roomful of red-dressed women – and a number of men – enjoyed a heart-healthy afternoon tea with Associate Professor Robyn Gallagher from NM&H, who exhorted women to "know your numbers and know your risks."

Ischaemic (caused by restricted blood supply) heart disease and not breast cancer, is the leading cause of death for women in Australia. In 2002, ischaemic heart disease was the cause of 20 per cent of male deaths and 18.8 per cent of female deaths. The only significant difference between women's and men's risk for cardiac disease is that men's risk increases from 55 years old and women's from 65 years.

Professor Gallagher urged women to ask their health care practitioner to assess their cardiac risks along with their other check-ups, to know the warning signs and to know what to do when experiencing symptoms (call an ambulance).
Some helpful information
The vital numbers are blood pressure (BP), cholesterol (HDL and LDL), blood sugar, body mass index (BMI), the number of family members with heart problems, minutes spent active in a day, and age.
Cardiac warning signs:

* Chest discomfort in the centre of the chest that lasts for more than a few minutes (it may feel like pressure, squeezing, fullness or pain and it may come and go).
* Discomfort in one or both arms, the back, neck, jaw or stomach, especially if it occurs with shortness of breath.
* Other signs include nausea, light-headedness, or breaking out in a cold sweat.