Knowledge on Cardio-cerebrovascular Disease and Health Behaviors among Middle-aged Postmenopausal Women at Risk

Kyung Ae Kim; Seon Young Hwang

doi:10.7469/kjan.2016.28.4.424

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Kim and Hwang: Knowledge on Cardio-cerebrovascular Disease and Health Behaviors among Middle-aged Postmenopausal Women at Risk

Original Article

Korean J Adult Nurs 2016;28(4):424-435.

Published online: NaN August 2016

DOI: https://doi.org/10.7469/kjan.2016.28.4.424

Knowledge on Cardio-cerebrovascular Disease and Health Behaviors among Middle-aged Postmenopausal Women at Risk

Kyung Ae Kim, MSN, RN¹, Seon Young Hwang, Ph.D., RN^2,

^¹Nurse, Gangnam Severance Hospital ․ Doctoral Student, Hanyang University, Seoul

^²Professor, College of Nursing, Hanyang University, Seoul, Korea

Corresponding author: Hwang, Seon Young College of Nursing, Hanyang University, 222 Wangsimni-ro, Seondong-gu, Seoul 04763, Korea. Tel: +82-2-2220-0702, Fax: +82-2-2220-1163, E-mail: seon9772@hanyang.ac.kr

Received 13 May 20166 August 2016 Accepted 23 August 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study examined knowledge about cardio-cerebrovascular disease (CVD) and its relationship to health behaviors among middle-aged postmenopausal women with CVD risk factors.

Methods

The study was a cross-sectional descriptive study. One hundred and thirty-six postmenopausal women were recruited from outpatient departments of four hospitals. The women were 60.69±6.5 years old. Self-reported questionnaires were administered, and waist-hip ratios (WHR) were measured.

Results

Among the women, 72.8% reported hypertension, 19.1% reported diabetes, 33.8% reported hypercholesterolemia, and 24.2% reported angina pectoris. Moreover, 73.9% of the women reported not knowing of CVD prevention, and only 26.1% reported exercising regularly. A majority of the women (80.9%) had a WHR > 0.85. Multiple linear regression analysis after adjusting for age and marital status indicated that the risk of myocardial infarction and stroke increased (p<.001). Waist-hip ratio≤0.85 (p=.022) and living with family members (p=.006) were significant predictors of healthier behaviors (R²=0.21, p<.001). Knowledge of CVD and health behaviors were not correlated.

Conclusion

Obese women and women who live alone are no more likely to practice health behaviors aimed at CVD prevention than their counterparts in the sample. Education and exercise interventions are needed, especially for obese women, to promote healthy behaviors among middle-aged postmenopausal women with CVD risk factors.

Keywords: Cardiovascular disease, Cerebrovascular disease, Knowledge, Health behavior, Waist-hip ratio

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Figure 1.

Percentage of correct answer to myocardial infarction and stroke symptoms and risk factors.

Table 1.

Sociodemographic Characteristics of the Participants (N=136)

Characteristics	Categories	n(%)	M±SD
Age (year)	45~59	52 (38.2)	60.7±6.5
Age (year)	60~69	84 (61.8)
Education level	≥High school	74 (54.4)
Education level	≤Middle school	58 (42.6)
Marital status	Married	104 (76.5)
Marital status	Widowed, single, divorced	32 (23.5)
Living with	Spouse or children	105 (82.0)
Living with	Alone	23 (18.0)
Household monthly income (10,000 won)	＜100	32 (24.1)
	100~300	53 (39.8)
	≥300	48 (36.1)
Job	Yes	43 (32.1)
Job	None or housewife	91 (67.9)
Regular physical exercise	≥3/week	48 (26.1)
	＜3/week	51 (38.1)
	None	48 (35.8)
Age at menopause			50.52±4.11
Experience of physical examination	Yes	89 (65.9)
Experience of physical examination	No	46 (34.1)
Education experience for CVD prevention	Yes	36 (26.5)
Education experience for CVD prevention	No	100 (73.5)
Information source on CVD	Television	81 (64.8)
	Hospital	37 (29.6)
	Public health center & newspaper	7 (5.6)
Perceived risk of CVD incidence	Occasionally & frequently	101 (74.3)
Perceived risk of CVD incidence	None	35 (25.7)
Awareness of AMI and stroke in the usual	I know well & try to be careful	100 (73.5)
Awareness of AMI and stroke in the usual	Not mind	36 (26.5)
Expected action when witnessed stroke or heart attack	Call 119	117 (86.1)
Expected action when witnessed stroke or heart attack	I don't know	19 (13.9)
Awareness of CVD risk increase after menopause	I know	56 (41.5)
Awareness of CVD risk increase after menopause	I don't know	79 (58.5)
Hormone therapy experience	Yes	29 (24.5)
Hormone therapy experience	No	89 (75.5)

Table 2.

Disease-related Characteristics of the Participants (N=136)

Variables	Categories	n(%)	M±SD
Risk factors for CVD^†	Hypertension	99 (72.8)
	Diabetes	26 (19.1)
	Dyslipidemia	46 (33.8)
	Angina	33 (24.2)
	Arrhythmia, fat liver, arthritis	25 (18.3)
CVD risk classification	High risk^‡ group At risk^§ group	52 (38.2) 84 (61.8)
Family history^†	Yes	65 (47.8)
	Hypertension	40 (29.4)
	Angina, CAOD, Stroke	38 (28.0)
	Diabetes	22 (16.2)
	Etc	2 (1.5)
Waist-hip ratio (n=131)	＞0.85	106 (80.9)	0.93±0.75
Waist-hip ratio (n=131)	≤0.85	25 (19.1)	0.93±0.75
Body mass index (kg/m²)	≤25	41 (30.1)	24.93±4.03
	＞25~29	37 (27.2)
	≥30	58 (42.7)
Waist-height ratio (n=131)	＞0.52	53 (40.5)	0.54±0.08
Waist-height ratio (n=131)	≤0.51	78 (59.5)	0.54±0.08

CVD=cardiocerebrovascular disease; CAOD=coronary artery occlusive disease;

^† Multiple response;

^‡ High risk includes the presence of documented CVD, diabetes, end-stage renal disease, 10-year predicted risk for CVD ≥10%;

^§ At risk includes the presence of ≥1 major risk factors, metabolic syndrome, evidence of subclinical vascular disease, treated hypertension.

Table 3.

Knowledge and Health Behavior for CVD Prevention (N=136)

Variables	Categories	n (%) or M±SD
Knowledge for CVD prevention	Nicotine in cigarettes makes it increased your blood pressure, pulse	98 (72.1)
	Even if you smoke yourself, secondhand smoke is harmful to health	133 (97.8)
	Moderate exercise is good treatment for smoking cessation	103 (75.7)
	After drinking alcohol shed a lot of sweat in the sauna Alcoholic minutes to exit the sweat liquor wakes up soon	110 (80.9)
	Regardless of the amount of drinking, do not drink at least three days in order to protect the liver	91 (66.9)
	Egg yolk, quail egg, and shrimp should be restricted because it contains a lot of cholesterol	104 (76.5)
	When consumed for a long time, salty foods can be elevated blood pressure	125 (91.9)
	Excessive intake of high-carbohydrate (rice, bread, chocolate, coffee, etc.), it would increase the triglycerides	99 (72.8)
	Fiber foods is good to prevent the accumulation of cholesterol and obesity	113 (83.1)
	Weight control is helpful in hypertension, diabetes, hyperlipidemia prevention	125 (91.9)
	Exercises reduces LDL increases the HDL	115 (84.6)
	It is effective in preventing metabolic syndrome that shorten the high intensity (running, soccer) than to continue the light exercises (walking, cycling slowly)	71 (52.2)
	Rapid and nervous personalities are more vulnerable to stress than relaxed and optimistic personality	119 (87.5)
Health behavior for CVD prevention	Regularly measure blood pressure	3.53±1.14
	Regularly measure blood glucose	2.66±1.36
	According to the doctor's prescription and taking medication	4.16±1.04
	It has received regular checks complications	3.21±1.33
	Has maintaining a standard body weight	2.76±1.19
	It maintains a waist circumference within the normal range	2.69±1.17
	Keeping the amount of food	3.15±1.16
	Maintain a low salt diet	3.02±1.23
	Each time you eat a meal of vegetables other than kimchi.	3.54±1.01
	30 minutes/once, and exercise more than 3 times a week	2.85±1.44
	30 minutes/once, and exercise more than 5 times a week	2.49±1.37
	Do not drink	4.35±1.04
	No smoking	4.69±0.94
	It has good stress management	3.07±1.16
	Sleep more than seven hours a day enough	2.94±1.26
	Sum	49.10±9.64

CVD=cardio-cerebrovascular disease; HDL=high-density lipoprotein; LDL=low-density lipoprotein.

Table 4.

Predicting Factors on Health Behavior for CVD Prevention (N=136)

Variables	B	SE	β	t	p
(Constant)	24.71	10.34		2.39	＜.001
Age	0.14	0.13	.09	1.10	.274
Marital status	2.10	1.06	.19	1.98	.057
Living with family	6.27	2.27	.26	2.76	.007
Waist-hip ratio (≤0.85)	4.49	1.97	.19	2.28	.024
Awareness of AMI and stroke in the usual	3.25	0.86	.31	3.77	＜.001
R²=.21, Adjusted R²=.17, F=6.05, p＜.001

CVD=cardio-cerebrovascular disease; AMI=acute myocardial infarction.

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