Public knowledge of cardiovascular disease and response to acute cardiac events in three cities in China and India

Objective: To inform interventions targeted towards reducing mortality from acute myocardial infarction (AMI) and sudden cardiac arrest in three megacities in China and India, a baseline assessment of public knowledge, attitudes and practices was performed. Methods: A household survey, supplemented by focus group and individual interviews, assessed public understanding of cardiovascular disease (CVD) risk factors, AMI symptoms, cardiopulmonary resuscitation (CPR) and automated external defibrillators (AEDs), plus emergency service utilisation and barriers to care. Results: 5456 household surveys were completed. Hypertension was most commonly recognised among CVD risk factors in Beijing and Shanghai (68% and 67%), while behavioural risk factors were most commonly identified in Bangalore (smoking 91%; excessive alcohol consumption 64%). Chest pain/discomfort was reported by at least 60% of respondents in all cities as an AMI symptom, but 21% of individuals in Bangalore could not name any symptom. In Beijing, Shanghai and Bangalore, 26%, 15% and 3% of respondents were trained in CPR, respectively. Less than one-quarter in all cities recognised an AED. Emergency service utilisation rates were low, and many expressed concern about prehospital care quality. Conclusions: Overall, there was low to modest knowledge of CVD risk factors and AMI symptoms, infrequent CPR training and little understanding of AEDs. Interventions must focus on basic CVD principles and complications to enable timely, appropriate care for acute cardiac events.

Herbert C Duber, Claire R McNellan, Alexandra Wollum, Bryan Phillips, Kate Allen, Jonathan C Brown, Miranda Bryant, R B Guptam, Yichong Li, Piyusha Majumdar, Gregory A Roth, Blake Thomson, Shelley Wilson, Alexander Woldeab, Maigeng Zhou, Marie Ng