Two hearts one future: a report of patients' & carers' experiences in surviving and coping with a first heart attack

Public health Diseases Diseases Australia

This report finds that many heart attack survivors underestimate their risk of having a future heart attack.

Executive summary

Preventative Health at the Baker IDI Heart and Diabetes Institute, under the auspices of the NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease, undertook a national survey to explore the experiences of individuals who survived their first heart attack (“subjects”). It also explored equivalent experiences in those caring (“carers”) for such individuals (but not necessarily the same ones who responded to the survey).

We studied 536 subjects (average age 64 years) and 511 carers (average age 55 years) from all parts of Australia. While there were more male subjects (72%), there were more female carers (79%). Overall, the study cohort was broadly representative of those affected by heart attack in Australia, despite their self-selected status.

We found:

  • Broad misperceptions in both subjects and carers, regardless of socio-economic status, concerning the underlying causes and triggers of heart attacks with an over-emphasis on psycho-social factors (including stress). These were not attenuated by attendance at a cardiac rehabilitation program.
  • Subjects were exposed to contemporary modes of management associated with their event; the majority experienced their first heart attack more than 3 years previously and around half attended a cardiac rehabilitation program.
  • Consistent with contemporary observations, around two thirds of subjects could recall their blood pressure and lipid levels.
  • Around one third of individuals had elevated blood pressure and lipid levels that increased their risk of a secondary cardiovascular event.
  • Adherence to health lifestyle regimes remains challenging (particularly in women) despite high levels of recognition of the importance of a healthy lifestyle plan.
  • Cardiac rehabilitation attendance was associated with more positive attitudes to healthy lifestyles (with similar challenges), whilst those who could afford to exercise most (high income individuals) did so.
  • Overall, there were high levels of self-reported treatment adherence with some important differences between men and women and marginal benefits of cardiac rehabilitation also noted.
  • Perhaps the response of carers to treatment adherence was more realistic and therefore lower than that reported by subjects.
  • Overall, carers appeared to be more deeply affected (both physically and emotionally) following a heart attack when examining perceptions of illness.
  • Cardiac rehabilitation appeared to “sensitise” individuals to the potential adverse consequences of a heart attack, whilst enhancing perceptions of the importance of treatment and education for both subjects and carers.
  • Male subjects had better overall quality of life than their female counterparts, with the notable exception of emotional status.
  • Those with higher incomes indicated better overall quality of life.
  • Female subjects and carers demonstrated better levels of knowledge in recognising the warning signs and symptoms of a repeat heart attack.
  • However, overall levels of awareness and knowledge concerning secondary events were poor, with only marginal improvements in such levels associated with cardiac rehabilitation.

Overall, these data provide a framework for improving our collective understanding of the causes and consequences of heart attack; particularly from the combined patient and carer respective. We found numerous misperceptions around heart attacks in those one might suspect would “know better”. We therefore need to improve education and support programs.

Principal investigator: Professor Simon Stewart.

Research team: Dr Yih Kai Chan, Dr Melinda Carrington and Ms Alicia Calderone.

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