Heart major disease
Heart disease is the leading cause of death in the United States (1). Heart attacks (also known as myocardial infarctions) occur when a portion of the heart muscle does not receive adequate blood flow, and they are major contributors to heart disease, with an estimated 750,000 occurring annually (2). Early intervention is critical for preventing mortality in the event of a heart attack (3). Identification of heart attack signs and symptoms by victims or bystanders, and taking immediate action by calling emergency services (9-1-1), are crucial to ensure timely receipt of emergency care and thereby improve the chance for survival (4). A recent report using National Health Interview Survey (NHIS) data from 2014 found that 47.2% of U.S. adults could state all five common heart attack symptoms (jaw, neck, or back discomfort; weakness or lightheadedness; chest discomfort; arm or shoulder discomfort; and shortness of breath) and knew to call 9-1-1 if someone had a heart attack (5). To assess changes in awareness and response to an apparent heart attack, CDC analyzed data from NHIS to report awareness of heart attack symptoms and calling 9-1-1 among U.S. adults in 2008, 2014, and 2017. The adjusted percentage of persons who knew all five common heart attack symptoms increased from 39.6% in 2008 to 50.0% in 2014 and to 50.2% in 2017. The adjusted percentage of adults who knew to call 9-1-1 if someone was having a heart attack increased from 91.8% in 2008 to 93.4% in 2014 and to 94.9% in 2017. Persistent disparities in awareness of heart attack symptoms were observed by demographic characteristics and cardiovascular risk group. Public health awareness initiatives and systematic integration of appropriate awareness and action in response to a perceived heart attack should be expanded across the health system continuum of care.
symptoms of Heart disease
NHIS is an annual survey that collects health-related information on the civilian, noninstitutionalized U.S. population (6). In 2008, 2014, and 2017, the survey asked questions about symptoms of a heart attack and the best action to take when someone was thought to be having a heart attack. Five yes/no questions assessed whether the respondent was aware of these five symptoms of heart attack: 1) pain or discomfort in the jaw, neck or back; 2) feeling weak, lightheaded, or faint; 3) chest pain or discomfort; 4) pain or discomfort in the arms or shoulder; and 5) shortness of breath. Respondents were then asked, “If you thought someone was having a heart attack, what is the best thing to do right away?” The appropriate response was “Call 9-1-1” (or another emergency number). The total sample sizes were 21,781 (2008), 36,697 (2014), and 26,741 (2017). After excluding approximately 1% of respondents with missing information, the final analytic samples were 21,525 (2008), 36,289 (2014), and 26,480 (2017).
Descriptive characteristics of respondents included sex, age, race/ethnicity, and the highest level of education achieved. History of coronary heart disease (a condition caused by narrowing of the arteries that supply blood to the heart) included a reported history of coronary heart disease, myocardial infarction, or angina pectoris. Five selected self-reported cardiovascular disease (CVD) risk factors included hypertension (high blood pressure), high blood cholesterol, diabetes, current smoking, and obesity (body mass index ≥30 kg/m2 calculated from self-reported weight and height). Presence of CVD risk factors were evenly weighted and summed
Dangerous for health
The prevalences of awareness of all five common heart attack symptoms, as well as the appropriate response when recognizing a heart attack (unadjusted and adjusted for age, sex, race/ethnicity, level of education, history of coronary heart disease, and number of CVD risk factors) were estimated overall and by selected demographic characteristics and CVD risk factors in 2008, 2014, and 2017. P-values for difference from 2008 to 2017 were obtained using the t-test; p-values <0.05 were considered statistically significant. During the three study years, the adjusted percentage of all survey respondents aware of the five common heart attack symptoms increased from 39.6% (2008), to 50.0% (2014), and to 50.2% (2017) (p-value for difference <0.001) (Table 1). Similar increases were observed in the unadjusted percentages and in all subgroups by demographic characteristics and CVD risk factors, except among those with four or five CVD risk factors. In 2017, knowledge of the five heart attack symptoms was lower among men, younger age groups, racial/ethnic minorities (especially non-Hispanic Asians and Hispanics), and persons with lower levels of educational attainment than among women, older adults, non-Hispanic whites, and adults with at least a high school education.