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Women Veterans' Cardiovascular Knowledge, Risks and Exercise Behavior in the Primary Care Setting
Bean-Mayberry BA, Clair K, Chanfreau CC, Schweizer CA, Brunner JW, Than CT, Dyer KE, Moreau JL, Huynh AK, Moin T, Finley E. Women Veterans' Cardiovascular Knowledge, Risks and Exercise Behavior in the Primary Care Setting. [Abstract]. American journal of preventive cardiology. 2020 Sep 1; 3(Supplement):13.
Background: One in three American women die of cardiovascular disease (CVD) annually, and extensive evidence shows that lifestyle behaviors contribute detrimentally to CVD risk. The objective of this analysis was to examine knowledge, health risks and health behavior characteristics of women Veterans interested in CVD risk reduction.
Methods: We surveyed women Veterans in 4 VA primary care clinics exposed to a CV toolkit designed to increase patient engagement, set goals and reduce CV risk. Our survey included measures of CV knowledge, risk factors, health status, health behaviors, as well as goal setting in last six months.
Results: Among 140 respondents (mean age 61, range 26-88), most ( > 90%) identified chest pain, discomfort in arm/shoulder, and shortness of breath as heart attack symptoms, and a smaller majority identified feeling weak/lightheaded (80%) or pain in jaw/neck (78%). Most (96%) reported at least one CV risk factor, and 60% had 3+ risks (e.g., smoking, HTN, hyperlipidemia, diabetes, obesity/overweight, depression, auto-immune disorders). For health status, women reported fair/poor ratings in overall health (30%), physical health (39%) and mental health (30%). However, only 42% reported they were personally at-risk and only 31% were worried about their CV risk, yet 75% believed diet, exercise and smoking determine CVD development. We found 54% of respondents set a behavioral goal with their provider in last 6 months, but only 30% reported moderate to strenuous exercise (of any duration) > 3 days/week.
Conclusions: Nearly all women had a CV risk factor; over half reported 3+ risks. However, less than half perceived themselves at-risk and less than one-third were concerned. This disconnect between identifying one's CV risk and perceiving it as a problem may be a gap in patient-provider communication about personal risk. While reassuring that 54% of respondents set behavioral goals with the provider, only a small number exercised regularly. For behavior change, it remains critical that we motivate all women to exercise regularly (for any duration) as a life-long activity for risk reduction and other benefits (mobility/fall prevention). Thus, it becomes important to assess kinds of exercise adults can perform and training for those with physical impairments.