CARDIOVASCULAR JOURNAL OF AFRICA • Volume 35, No 3, September – October 2024 AFRICA 183 what their medication does for them. However, the majority (75.2%) of participants were reported to be compliant with all medication doses and frequencies.12 Younger and middle-aged patients with an increased ability for self-management and more co-morbid conditions were found to have higher levels of medication knowledge as opposed to older participants who were taking more medication.12 The latter could be influened by impaired cognitive function associated with older age as well as increased complexity of medication regimes in the elderly. The increased knowledge of participants with more co-morbid conditions may have been attributed to the choice of the population group, as it focused on heart failure and COPD. As medication taken for CVD prevention are intended for chronic use, it is extremely important to recognise and address factors that improve adherence to achieve maximum clinical effectiveness as well as cost effectiveness.30 It is imperative that efforts are made to reduce the global CVD burden. The evaluation and treatment of diet, exercise and smoking should become a routine practice similar to blood pressure, cholesterol and glucose monitoring. Target areas for intervention Misconceptions must be meticulously dealt with to avoid bias or cultural stigmatisation. Common themes and key aspects from various studies are summarised in Fig. 2. There is a gap identified for the need for regular monitoring for cardiovascular health. The consequences that stem from failure to adhere to medical therapy can be addressed by increasing awareness through campaigns and educational programmes. Effective policy measures and surveillance, together with public awareness must be taken into consideration so that behaviours can be developed, enforced and easily implemented. There is a need for a paradigm shift that maximises healthcare workers’ potential to increase public knowledge of CVD risk factors and warning signs, especially in rural areas.2 Awareness programmes that highlight the implication of adverse risk factors relating to CVD cannot be over emphasised. Cost-effective community health educational interventions, taking into consideration socio-economic status and cultural beliefs, may be beneficial.17 Community understanding of CVDs has had significant positive consequences,31 and studies have shown that increasing a patient’s knowledge of CVD and its risk factors can lead to success in control and prevention.2 CVD health programmes can be used to influence attitudes and practices towards a healthy lifestyle, improved treatment compliance and decreased risk of complications.24 Understanding disparities in patients’ perception, knowledge and practice is crucial for designing and implementing appropriate interventions to combat the rising burden of non-communicable diseases.2 Conclusion Overall, low perceptions and insufficient knowledge of CVDs continue to be indispensably important factors in health behaviour. Knowledge perceptions showed variations among different populations, and different ethnic groups were influenced by level of education, place of residence and type of employment. Different population groups require different educational material to improve their level of comprehension and understanding. Meticulous understanding of the knowledge gaps and perceptions of CVD is critical to inform and lead to the development of appropriate targeted health awareness and promotional campaigns to prevent CVD events in high-risk populations in our setting. Future CVD awareness strategies should emphasise that end-organ damage is preventable, and assist individuals to comprehend and manage the risk factors. A focus on primary and secondary prevention is crucially important. Prompt Understanding of CVD Need for monitoring Risk-factor awareness Medication compliance Lifestyle modification • No global standardisation present • Low to moderate awareness and knowledge of CVD • Uninformed due to poor health care communication • Patients only seek medical help when symptomatic • Often miss follow-up appointments • Failure to recognise chronicity of cardiovascular disease • The concept of risk factors is often confused with the “risk”associated with non-adherence • Common risk factors known are stress, smoking, unhealthy diet, physical inactivity, obesity • Lower educational level associated with lower levels of knowledge • Recognised need for long-term treatment • Lacks insight but adheres to doctors’ advice • Takes medication only when symptomatic • Increased knowledge proportional to number of co-morbidities • Healthy living is not seen as affordable despite awareness • Lower educational level is associated with less knowledge and an unhealthy lifestyle • Overweight patients perceive themselves to be underweight • Lack of awareness of calorie reduction Fig. 2. Key aspects for the improvement of CVD health.
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