Social inequality in awareness of cardiovascular risk factors in patients undergoing coronary angiography

Background: In order to improve their risk profile, individuals need to be aware of the existence of cardiovascular (CV) risk factors. The awareness of CV risk factors has not yet been studied in patients undergoing coronary angiography. Patients and Methods: A total of 4,500 patients undergoing coronary angiography were asked to complete a questionnaire before the procedure. The patients were asked about their economic status, their education, their source of health information and were also asked to name CV risk factors. Results: The prevalence of coronary artery disease (CAD) (87%) and CV risk factors was high. Hypertension and hypercholesterolemia were the two most common CV risk factors and were found in two thirds of the patients. There were significant differences in the awareness of risk factors across the different levels of education. Only 8% of the men and 7% of the women could cite at least three risk factors. This percentage ranged from 4% of the patients with primary level of education to 11% and 20% of the patients with secondary and university levels of education, respectively (p < 0.001). More than 1 out of 10 patients did not know any CV risk factor. Smoking and hypercholesterolemia were the best identified CV risk factors in contrast to diabetes and hypertension. The primary care physician was the major source of information across all levels of education. Conclusion: Awareness of CV risk factors is low in this high-risk population and associated with strong social inequalities. This information is alarming and will have to be addressed in order to improve outcomes in patients with CAD.