CARDIOVASCULAR JOURNAL OF AFRICA • Volume 33, No 4, July/August 2022 AFRICA 181 The survey was designed to examine epidemiological information such as age, gender, educational status, place of residence, as well as answers to 16 questions related to symptoms of HF and methods of treatment of this condition. The patients were asked: • whether they were connected to any area of healthcare • whether they suffered from HF • whether their relatives suffered from HF • whether they suffered from other cardiovascular diseases • to evaluate their knowledge about HF (scale of 1–5); 1: no knowledge, 2: poor, 3: fair, 4: good, 5: very good • whether the following symptoms relate to HF: fatigue, upper/ lower limb oedema, excessive thirst, sweating, dyspnoea, cough, nausea, headache, chest pain, increase in body mass, excessive appetite, dizziness, loss of body mass, insomnia, hot flush, palpitation, anxiety, syncope • whether HF is equivalent to myocardial infarction • whether HF is a fatal disease • to assess their knowledge about the risk factors of HF (scale of 1–5); 1: no knowledge, 2: poor, 3: fair, 4: good, 5: very good • whether the following symptoms have an influence on HF: arterial hypertension, thyroid disease, diabetes, nicotine addiction, obesity, stress, excessive physical activity, female gender, hypercholesterolaemia, renal disease, alcohol abuse, lack of physical activity, neoplasm/tumour • whether the person suffering from HF should avoid physical activity • whether the person suffering from HF can play sport • to choose methods of treatment of HF: heart surgery, stimulator, physical activity, diet, pharmacotherapy, psychologist support, don’t know • whether HF is treatable • to name their source of knowledge on diseases and healthy lifestyle: general practitioner, specialist, registered nurse, relatives, other ill people, radio, television, internet, professional leaflets • whether they need more information about HF. Statistical analysis Statistical analysis was performed using STATISTICA 12 Statsoft. The probability of distribution of continuous variables was tested with the Shapiro–Wilk test and Liffefors. The Student’s t-test was used to compare continuous variables with a normal distribution and the Mann–Whitney U-test was used for continuous variables with a non-normal distribution. Chi-squared tests were used for categorical variables, with Yate’s correction where applicable. A p-value of < 0.05 was considered statistically significant for all the tests. Results The study analysed responses from 501 participants gathered in an internet survey carried out in 2020. The mean age of the research group was 32 ± 14 years (76% < 40 years) and 74% of the respondents were women; 50% of the participants lived in cities with > 60 000 inhabitants and 57% had obtained higher education. A respectively large group of respondents (45%) consisted of people associated with the health services. Only 6% of the participants were affected by HF, whereas 33% of responders had relatives suffering from HF (Table 1). Among the study group, 27% of respondents assessed their knowledge of HF symptoms inclusively as good or very good, and 29% of participants assessed their understanding of HF risk factors as good or very good (Fig. 1). The most characteristic symptoms of HF for each of the age groups were dyspnoea (p = 0.08), palpitation (p = 0.26), lowerlimb oedema (p = 0.94) and fatigue (p = 0.95) (in descending order). The most frequently indicated symptom of HF was dyspnoea; 94% of young people chose this symptom, 90% of middle-aged people and 81% of elderly people. A significant Table 1. Baseline characteristics of the study population (n = 501) Characteristics Number (percent) Age (years), mean ± SD 32 ±14 Male gender 130 (26) Age < 40 years 381 (76) Age 40–65 years 93 (19) Age > 65 years 27 (5) Village 121 (24) City < 10 000 28 (6) City 10 000–60 000 101 (20) City > 60 000 252 (50) Elementary education 8 (2) Vocational education 24 (5) Secondary education 182 (36) Higher education 287 (57) People connected with health services 225 (45) People suffering from HF 32 (6) People whose relatives suffer from HF 164 (33) Arterial hypertension 65 (13) Heart arrhythmia, e.g. atrial fibrillation 37 (7) Ischaemic heart disease (coronary heart disease) 10 (2) Previous myocardial infarction 10 (2) Valve disease 3 (1) Cardiac pacemaker (or ICD, or CRT) 11 (2) Aortic aneurysm 2 (0) Deep venous thrombosis 5 (1) Stroke/TIA 3 (1) HF, heart failure; ICD, implantable cardioverter defibrillator; CRT, cardiac resynchronisation therapy; TIA, transient ischaemic attack. 50 40 30 20 10 0 Patients (%) 1–none 2–poor 3–fair 4–good 5–very good Symptoms of HF Risk factors of HF 8% 8% 27%27% 38% 35% 21% 22% 6% 7% Fig. 1. Awareness of symptoms and risk factors of HF among the study groups (n = 501). HF, heart failure.
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