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Original research
Public knowledge of cardiovascular disease and response to acute cardiac events in three municipalities in Brazil
  1. Emily S Bartlett1,
  2. Luisa S Flor2,
  3. Danielle Souto Medeiros3,
  4. Danny V Colombara4,
  5. Casey K Johanns2,
  6. Fernando Antonio Camargo Vaz5,
  7. Shelley Wilson2 and
  8. Herbert C Duber1,2
  1. 1 Department of Emergency Medicine, University of Washington, Seattle, Washington, USA
  2. 2 Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
  3. 3 Federal University of Bahia, Vitoria da Conquista, Brazil
  4. 4 Public Health - Seattle & King County, Seattle, Washington, USA
  5. 5 Federal University of Minas Gerais, Belo Horizonte, Brazil
  1. Correspondence to Dr Herbert C Duber; hduber{at}


Objective To conduct a landscape assessment of public knowledge of cardiovascular disease risk factors and acute myocardial infarction symptoms, cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) awareness and training in three underserved communities in Brazil.

Methods A cross-sectional, population-based survey of non-institutionalised adults age 30 or greater was conducted in three municipalities in Eastern Brazil. Data were analysed as survey-weighted percentages of the sampled populations.

Results 3035 surveys were completed. Overall, one-third of respondents was unable to identify at least one cardiovascular disease risk factor and 25% unable to identify at least one myocardial infarction symptom. A minority of respondents had received training in CPR or were able to identify an AED. Low levels of education and low socioeconomic status were consistent predictors of lower knowledge levels of cardiovascular disease risk factors, acute coronary syndrome symptoms and CPR and AED use.

Conclusions In three municipalities in Eastern Brazil, overall public knowledge of cardiovascular disease risk factors and symptoms, as well as knowledge of appropriate CPR and AED use was low. Our findings indicate the need for interventions to improve public knowledge and response to acute cardiovascular events in Brazil as a first step towards improving health outcomes in this population. Significant heterogeneity in knowledge seen across sites and socioeconomic strata indicates a need to appropriately target such interventions.

  • coronary artery disease
  • emergency medicine
  • resuscitation
  • acute coronary syndrome
  • delivery of care

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  • Contributors HCD and LSF conceptualised the study and developed the survey instrument. LSF, DVC, CKJ and SW contributed to development of the survey instrument, data collection, and data management, verification and analysis. DSM and FACV managed data collection activities. ESB and LSF performed the analysis. ESB wrote the first draft of this manuscript. All authors read, contributed to and approved the final manuscript.

  • Funding Funding was provided by the Medtronic Foundation.

  • Disclaimer The funder had no role in study design, data collection, data analysis, decision to publish or preparation of the manuscript.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Ethical approval was obtained from the University of Washington and local institutional review boards in Padre Paraíso (University Hospital of the University of Minas Gerais), Poções (Federal University of Bahia), and Vitória da Conquista (Federal University of Bahia). Written informed consent was obtained prior to participating in the study and recorded in the survey software. Illiterate patients had consent information presented orally and oral consent was documented in the presence of a witness.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Deidentified participant data are available upon reasonable request from the Institute for Health Metrics and Evaluation at the University of Washington.

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