The study revealed that 71.4% of CVD patients had satisfactory knowledge regarding CV risk factors. However, studies conducted in south east Asian countries of Bangladesh(16),Malaysia(17), and Republic of Korea(18) reported 38.9%, 55.6% and 41% respectively. Their report is significantly lower than ours. This discrepancy might be due to lack of health awareness trainings on area of CVD which is a routine procedure among CVD patients in our study setting, socio-demographic differences, study time gap and study setting difference.
Studies from Africa reported mean knowledge of patients towards CVD risk factors to be 32.1%, 49.4% while a systematic review from Sub Saharan Africa revealed a mean knowledge level ranging from 4.4%-68.1% (13, 19, 20)which are significantly lower than our study. These differences can be due to different measurement tools, difference in socioeconomic background, lack of awareness creation events, poor patient counseling, lack of effective communication with physicians and absence of independent CVD units equipped to deal with sustainable Cardiovascular patient care in the former studies.
Studies from Eastern and Northern Ethiopia reported mean Knowledge of 54% and 32.2% respectively(8, 21). The observed difference could be due to the fact that our participants are largely urban dwellers located in the capital city compared with the formers.
Our rates of CVD risk factors literacy echoes findings of previous studies from Tanzania(22), South Africa(23), and Iran(24) where findings were 80%, 75% and 78.7% respectively. This observed similarity in literacy rates could be explained by the education-level similarities among study participants and similarity of tools used for knowledge assessment, similarity of study setting
Among individual risk factors related knowledge observed from literatures, smoking(17, 23, 25) mentioned to constitute 36.2–93.2% of participants, alcohol intake in excess explained by 40.7%(26) and by 65%(27) by Lebanon population. Unhealthy diet was mentioned by 2.8–88% in multiple studies(8, 17, 25–27) while physical inactivity was explained by 1.2– 96%(17, 23, 25, 27).Further more excess body weight was explained by 1.6–100% to be risk factors(17, 25, 27) while hypertension(17, 25, 27) was explained by 6.2–94%.In addition, diabetes(17, 23, 27) was explained by 5.3–92.4%. Meanwhile our study revealed, Smoking 11.9%, Excess alcohol intake 9%, unhealthy diet 46.4%, Physical inactivity 50% and excess body weight 57.9% as an individual risk factors for CVD. Our participants had significant knowledge on being overweight (90.1%), regular physical activity (89.1%), keeping blood pressure (88.8%) and smoking (87.7%). At the same time patients had deficient knowledge about eating a high fiber diet (29%), only exercising at gym (46.5%) and family history (44.1%).
In our study four independent variables (Age ([AOR=0.2; 95%CI (0.9-0.45)]), Sex ([AOR=0.46; 95%CI (0.3-0.8)]), place of residence ([AOR=4.2; 95%CI (1.9-9.5)]) and educational status ([AOR=0.18; 95%CI (0.07-0.43)])) were found to have significant statistical correlation with Knowledge towards risk factors of CVD. Meanwhile after adjusting cofounders married patients were found to be 53% more likely to have satisfactory behavior [AOR=0.47; 95%CI (0.23-0.92)].
Residence, education level and marital status were associated with knowledge of cardiovascular risk factors(8) thus, social, cultural and economic factors are major determinants of health literacy. As that of our result multiple studies (8, 20, 25) revealed direct relation of educational status and health literacy. A review from Sub-Saharan Africa reported that place of residence is associated with improved knowledge of CV risk factors(28). In Ethiopia, rural residents attain lower educational level and have poor access to health information as compared to urban residents who relatively have better health literacy. Thus, low knowledge of CV risk factors in rural residents could be due to their lower education attainment.