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Recall of diagnosis by men with ischaemic heart disease
Insights
Many middle-aged British men have undiagnosed ischaemic heart disease. Low awareness among patients and doctors may hinder efforts to reduce cardiovascular disease incidence.
Area of Science:
- Cardiology
- Public Health
Background:
- Ischaemic heart disease (IHD) is a significant health concern in middle-aged British men.
- Patient awareness of cardiovascular disease diagnoses is crucial for disease management and prevention.
Purpose of the Study:
- To investigate the prevalence of self-reported cardiovascular disease diagnoses among middle-aged men.
- To assess the correlation between recalled diagnoses and objective evidence of ischaemic heart disease.
Main Methods:
- A study involving middle-aged men in 24 British towns.
- Data collection through questionnaires on chest pain and electrocardiography (ECG).
- Analysis of patient recall of doctor-diagnosed cardiovascular disease.
Main Results:
- 21% of men recalled a cardiovascular disease diagnosis; 25% of these had IHD.
- Recall of IHD diagnosis increased sixfold with age.
- Only 33% with possible myocardial infarction (MI) recalled a diagnosis; 50% with definite MI on ECG recalled IHD diagnosis.
- Even with severe angina, 40% couldn't recall a heart disease diagnosis.
- Overall, only 20% of men with IHD recalled a doctor's diagnosis, typically those most severely affected.
Conclusions:
- Ischaemic heart disease is prevalent in middle-aged British men, with many unaware of their condition.
- Low patient and physician awareness of IHD may impede public health initiatives.
- Improving diagnosis recall and awareness is vital for reducing IHD incidence in Great Britain.
Abstract:
In a study of the prevalence of ischaemic heart disease in middle aged men in 24 British towns, the subjects were asked whether a doctor had ever told them that they had any form of cardiovascular disease. Their recall of various diagnoses was related to evidence of ischaemic heart disease obtained by an administered questionnaire on chest pain and electrocardiography. Twenty one per cent of men recalled a diagnosis of cardiovascular disease, in one quarter of whom it was ischaemic heart disease. There was a sixfold increase in the prevalence of recall of a diagnosis of ischaemic heart disease over the age range studied. Only one third of the men with possible myocardial infarction on questionnaire recalled such a diagnosis having been made by a doctor. Only half of those with a definite myocardial infarction on an electrocardiogram could recall a diagnosis of ischaemic heart disease. Even in severe (grade 2) angina 40% could not recall being told that they had heart disease. Overall, only one in five of those regarded as having ischaemic heart disease was able to recall such a diagnosis having been made by a doctor, and these were likely to be those most severely affected. Ischaemic heart disease is common in middle aged British men, but most of those affected are apparently not aware of their condition. This low level of awareness among patients and doctors may contribute to a lack of public concern regarding the need for action to reduce the incidence of ischaemic heart disease in Great Britain.