CARDIOVASCULAR JOURNAL OF AFRICA • Volume 33, No 4, July/August 2022 182 AFRICA number of respondents also indicated syncope (83, 75 and 59%, respectively; p < 0.01) and headache (52, 38 and 44%, respectively; p = 0.02) (Table 2). Based on the ESC guidelines, we chose three main symptoms of HF, namely lower-limb oedema, dyspnoea and fatique, and checked how many respondents correctly indentified at least one of these.1 At least one sign of HF was correctly identified by 98% of the young group, 95% of the middle-aged group and 89% of the elderly group (p = 0.03). To assess their awareness of characteristic symptoms of HF, an analysis was conducted among the group of people whose relatives suffer/do not suffer from HF. In both groups the most frequently distinguished symptoms of HF were: dyspnoea (96 vs 91%; p = 0.30) or fatigue (89 vs 85%; p = 0.08). In the group where respondents’ relatives suffered from HF, participants were much more convinced symptoms such as lower-limb oedema (91 vs 82%; p = 0.02), excessive thirst (30 vs 23%, p = 0.01), sweating (64 vs 51%, p = 0.01), cough (55 vs 45%; = 0.01) and syncope (84 vs 81%; p = 0.03) were related to HF (Table 2). The majority of respondents stated that HF patients should not avoid physical activity (83 vs 83 vs 67%, respectively; p = 0.25), regardless of the age group, however a high percentage of them said they should avoid activity or did not have any idea on this issue. Half of the respondents in the elderly group indicated that HF patients may play sport, whereas the situation looked better in the younger groups (75 vs 69 vs 52%, respectively; p = 0.01) (Table 3). Most of the respondents in each group pointed to pharmacotherapy as a method of treatment of HF. However, change of lifestyle, determined by physical activity (57, 61 and 48%, respectively; p = 0.46) and diet (75, 77 and 67%, respectively; p = 0.53) were much less often chosen. Other methods of treatment were less frequently chosen by respondents but the answers did not differ significantly between the age groups (Table 3). The issue of physical activity was also studied in two groups of people: one group suffering from HF and the other not suffering from HF. Surprisingly, significantly more people suffering from HF claimed that physical activity should be avoided (p = 0.03) but in both groups, respondents believed that HF patients can play sport (p = 0.60) (Table 4). The analysis was also conducted in two groups of people whose relatives either suffered or did not suffer from HF. Relatives of HF patients indicated that HF patients should not avoid physical activity (p = 0.01) and may play sport (79%; p = 0.02) more frequently than those in the group in which relatives did not suffer from HF (Table 4). The majority of respondents who were analysed by age, considered HF a fatal disease and no significant difference was observed between the groups (58 vs 54 vs 63%, respectively; p = 0.89) (Fig. 2). Almost half of the participants (47%; p < 0.05) in the younger adult group believed HF to be incurable, whereas Table 2. ‘Do the following symptoms relate to HF?’ Responses by age group, and group of relatives suffering/ not suffering from HF and positive answers Symptoms Young (< 40 years) (%) Middle aged (40–65 years) (%) Elderly (> 65 years) (%) p-value Relatives suffering from HF (%) Relatives not suffering from HF (%) p-value Fatigue 87 81 70 0.95 89 85 0.08 Lower-limb oedema 84 87 81 0.94 91 82 0.02* Upper-limb oedema 46 34 26 0.06 45 44 0.60 Excessive thirst 27 16 22 < 0.01* 30 23 0.01* Sweating 54 56 52 0.10 64 51 0.01* Dyspnoea 94 90 81 0.08 96 91 0.30 Cough 48 46 44 0.34 55 45 0.01* Nausea 19 14 4 < 0.01* 23 15 0.06 Headache 52 38 44 0.02* 59 45 0.05 Chest pain 90 82 89 0.27 92 86 0.33 Increase in body mass 26 24 19 0.72 30 23 0.14 Excessive appetite 5 4 4 0.82 7 5 0.33 Dizziness 73 60 63 0.16 77 66 0.10 Loss of body mass 18 12 15 0.40 16 18 0.66 Insomnia 41 33 41 0.30 47 34 0.05 Hot flush 53 41 37 0.08 53 49 0.31 Palpitation 91 86 81 0.26 93 87 0.26 Anxiety 79 74 74 0.52 83 74 0.14 Syncope 83 75 59 < 0.01* 84 81 0.03* *Statistical significance with p < 0.05. HF, heart failure. Table 3. Awareness of physical activity and HF treatment by age group Responses Young (< 40 years), % (n) Middle aged (40–65 years), % (n) Elderly (> 65 years), % (n) p-value ‘Should HF patients avoid physical activity?’ 0.25 Yes 9 (36) 8 (7) 15 (4) No 83 (315) 83 (77) 67 (18) Don’t know 8 (30) 10 (9) 19 (5) ‘Can the HF patient play sport?’ 0.01* Yes 75 (285) 69 (64) 52 (14) No 14 (52) 10 (9) 22 (6) Don’t know 12 (44) 22 (20) 26 (7) ‘What are the methods of HF treatment?’ Heart surgery 52 (200) 47 (44) 59 (16) 0.79 Stimulator 62 (237) 54 (50) 44 (12) 0.08 Rest 37 (141) 35 (33) 30 (8) 0.73 Physical activity 57 (217) 61 (57) 48 (13) 0.46 Diet 75 (284) 77 (72) 67 (18) 0.53 Pharmacotherapy 82 (311) 85 (79) 81 (22) 0.75 Psychologist support 18 (69) 20 (19) 26 (7) 0.56 No idea 6 (21) 9 (8) 7 (2) 0.52 *Statistical significance with p < 0.05. HF, heart failure. Table 4. Awareness of physical activity by group of people suffering/ not suffering from HF and relatives suffering/not suffering from HF Responses Respondent suffering from HF, % (n) Resopndent not suffering from HF, % (n) p-value Relatives suffering from HF, % (n) Relatives not suffering from HF, % (n) p-value ‘Should the HF patient avoid physical activity?’ Yes 19 (6) 8 (35) 0.03* 4 (7) 11 (30) 0.01* No 81 (26) 83 (343) 91 (150) 79 (221) No idea 0 (0) 9 (36) 4 (7) 10 (29) ‘Can the HF patient play sport?’ Yes 66 (21) 73 (304) 0.60 79 (129) 71 (200) 0.02* No 16 (5) 14 (56) 10 (16) 13 (36) No idea 19 (6) 13 (54) 12 (19) 16 (44) *Statistical significance with p < 0.05. HF, heart failure.
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