Knowledge of Coronary Heart Disease Risk Factors among People in
Banda Aceh
Muhammad Ridwan
1,2
, Dara Masthurina
3
, Saminan
4
, Nirwana Lazuardi Sary
4
, and Taufik Suryadi
5,6
1
Departement of Cardiology, Medical Faculty, Universitas Syiah Kuala, Banda Aceh, Aceh,
Indonesia
2
Departement of Cardiology, Zainoel Abidin Provincial Hospital, Banda Aceh, Aceh, Indonesia
3
Medical Faculty, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia
4
Departement of Physiology, Medical Faculty, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia
5
Departement of Forensic and Medicolegal, Medical Faculty, Universitas Syiah Kuala, Banda Aceh, Aceh,
Indonesia
6
Departement of Forensic and Medicolegal, Zainoel Abidin Provincial Hospital, Banda Aceh, Aceh,
Indonesia
Keywords: Knowledge, Coronary Heart Disease, Risk Factors
Abstract: Coronary heart disease (CHD) is the major of the health problem in Indonesia, especially in Aceh Province.
To prevent CHD, it is important to know the knowledge level of CHD’s risk factors among individuals. The
high-knowledge level of CHD’s risk factors can increase the motivation of an individual to prevent the
developing risk factors. The aim of this study is to know the knowledge level of CHD’s risk factors among
Banda Aceh citizen. The descriptive cross-sectional was done among 384 subjects and interviewed with a
modified version of Heart Disease Fact Questionnaire (HDFQ). The result among 12 CHD’s risk factors
assessed, 3 risk factors of CHD marked low: menopause (31%), diabetes (44.3%), and HDL levels (46.1%).
In general, the knowledge of CHD’s risk factors among Banda Aceh citizen is low. Due to the high CHD’s
prevalence in Aceh Province, educational program is important to prevent the incidence of CHD among
Banda Aceh people.
1 INTRODUCTION
Coronary Heart Disease (CHD) is a heart disease
with an obstruction in coronary blood vessels. It is
the major health problem in the world due to the
high number of mortality and morbidity (WHO,
2017). In 2015, the main cause of death in the world
was CHD with more than 9 million death (WHO,
2016). The prevalence of CHD was increased in the
low-middle income country, it affected by the
lifestyle changing (Smith, 2012). Otherwise, the
prevalence of CHD significantly decrease in high-
income country in the latest decades (Moran, 2014).
The number of death caused by CHD in
Indonesia was the highest after stroke, 12.6% (SRS,
2014). The prevalence of CHD in Indonesia was
0.5% by diagnosis and 1.5% by diagnosis-symptoms
(Riskesdas, 2013). This problem became the main of
health expenditure in Indonesia, 39.6% (Bloom,
2014). In Indonesia, the high prevalence of CHD
found in Aceh Province. The prevalence of CHD in
Aceh is higher than national CHD’s prevalence,
0.7% and 2.3% (Riskesdas, 2013).
Even though CHD is a major health problem in
Indonesia, especially in Aceh. This disease can be
prevented by controlling the risk factors of CHD, for
instance hypertension, smoking, diabetes, obesity,
inactivity, hyperlipidemia, and diet (Piepoli, 2016).
The preventive actions of CHD’s risk factors will
success with a high-knowledge level of CHD’s risk
factors (Al Hamarneh, 2011). The study of the
women in the United States, awareness of
cardiovascular disease has been increased and also
reduced their risk factors. It is related by the
decreasing the death due to heart disease in women
(Mosca, 2004). In the latest decades, many
industrialized countries have been successfully
reduced the CHD prevalence by the implementation
of primary prevention (Cesare, 2012).
Ridwan, M., Masthur ina, D., Saminan, ., Sary, N. and Suryadi, T.
Knowledge of Coronary Heart Disease Risk Factors among People in Banda Aceh.
DOI: 10.5220/0008791902110215
In Proceedings of the 2nd Syiah Kuala International Conference on Medicine and Health Sciences (SKIC-MHS 2018), pages 211-215
ISBN: 978-989-758-438-1
Copyright
c
2020 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved
211
It is important to know the level knowledge of
CHD’s knowledge among individuals to reach the
effective action to prevent the risk factors. The
previous study in Oman found that people have a
low- knowledge level of CHD's risk factors
(Ammouri, 2016). The other study among first-
generation Filipino Americans in Southern Nevada
was found the high-knowledge level of CHD’s risk
factors (Angosta, 2014). There is no study that
shows the levels of CHD’s risk factors in Indonesia
or Aceh Province. This study conducted to know the
level knowledge of CHD’s risk factors among
people in Banda Aceh.
2 METHOD
This was a descriptive cross-sectional survey design.
Ethical approval was gained from the Ethical
Committee of Medical Faculty of Syiah Kuala
University. The data were collected from September
to October 2018 among covenience sample of 384
people in Banda Aceh. The population of this study
was people who attended Blang Padang, the city
park in Banda Aceh. The minimal sample was
calculated by Krecjie and Morgan sampling method.
The participants were a Banda Aceh citizen adult 18
– 60 years old who did not suffer from hearing loss,
not diagnosed with heart disease, and stay in Banda
Aceh at least for 6 months.
The modified version of the Heart Disease Fact
Questionnaire (HDFQ) was originally designed in
the previous study (Wagner et al, 2006). The using
of this questionnaire was with permission and
modified to adopt the condition of this study. The
questionnaire translated into Indonesian Language
officially done by UPT Pusat Bahasa Syiah Kuala
University. Validity and Reliability of this
questionnaire were retested and showed this
instrument was valid with r > 0,444 and high
consistency with Cronbach’s alpha was 0,884. The
modified version of HDFQ consist of 22 items
measured knowledge of CHD and the preventive
action to improve the CHD’s risk factors. Each item
of the questionnaire has three possible answers: true,
false, or unknown. The total number of the correct
answer (range: 0-22) was added and the result is the
score for knowledge of CHD’s risk factors. The
score ≥70% indicate high knowledge, whereas <70%
indicate low. The data collected by interviewing
participants and helped by the enumerators, medical
student of Syiah Kuala University. The data were
analyzed by descriptive test to know the percentages
of level knowledge of CHD’s risk factors.
3 RESULT AND DISCUSSION
3.1 Demographic Characteristics
The participants of this study were 384 people. Most
of them were female (64.8%) with a range of age 18-
24 years (45.6%). The social economic status was
48.7% high-educational level, 48.7% had low-
annual income, and 48.2% were unemployed.
50.8% of participant usually get the health
information from media, especially from social
media.
Table 1: Demographic characteristics of respondents (N =
384).
Characteristics
n (%)
Gender
Male
135 (35.2)
Female
249 (64.8)
Age
18-25 years (late adolescent)
175 (45.6)
26-35 years (early adult)
102 (26.6)
36-45 years (late adult)
71 (18.5)
46-55 years (early elderly)
26 (6.8)
56-60 years (late elderly )
10 (2.6)
Education level
Low (elementary – middle school)
20 (5.2)
Moderate (high school)
177 (46.1)
High (completed college)
187 (48.7)
Employment status
Unemployed
199 (51.8)
Employed
185 (48.2)
Montly income
Low (< Rp2.5 millions)
273 (71.1)
Moderate (Rp2.5 – Rp5 millions)
71 (18.5)
High (≥ Rp 5 millions)
40 (10.4)
Information Access
Family/friends
89 (23.2)
Media
195 (50.8)
Health workers
81 (21.1)
Workshop
19 (4.9)
3.2 Knowledge of CHD’s Risk Factors
Table 2: Knowledge of CHD’s risk factors (N=384)
Characteristics
n (%)
CHD Knowledge Score
Low (<70%)
202 (52.6)
High (≥70%)
182 (47.4)
The measurement knowledge level of CHD’s risk
factors among people in Banda Aceh indicate low
that is 202 participants (52.6%) and 182 participants
(47.4%) have high-knowledge level of CHD’s risk
SKIC-MHS 2018 - The 2nd Syiah Kuala International Conference on Medicine and Health Sciences
212
factors. The mean percentages CHD knowledge
score was 69.06%.
The result from this study parallel with the study
from other countries, there are in Oman and Kuwait
also have a low-knowledge level of CHD’s risk
factors. (Ammouri, 2016; Awad, 2014) The other
study in Southern Nevada has a high-knowledge
level of CHD’s risk factors (Angosta, 2014).
The participants in this study were aware about
some CHD’s risk factors (table 3). Many of them
answer correctly to the statement of smoking (n =
355; 92.4%), stress (n = 344; 89.6%), obesity (n =
332; 86.5%), high-cholesterol levels (n = 297;
77.3%), and high blood pressure (n = 294; 76.6%) as
CHD’s risk factors. They also have good knowledge
levels of the preventive action to CHD’s risk factors
(figure 4) such as: regular activity (n = 351; 91.4%),
stress control (n = 309; 80.5%), stop smoking (n =
318; 82.8%), and blood pressure monitoring (n =
302; 78.6%). But, most of them don’t aware the risk
factor of CHD in menopausal woman (n=119 orang;
31.0%), diabetes (n = 214; 55.7%) and HDL levels
(n = 207; 53.9%).
Table 3: The percentages of correct answer of modified
HDFQ among community sample of Banda Aceh people
(N = 384)
Statement
A person always knows when they have
CHD
If you have a family history of CHD, you
are at risk of developing heart disease
The older a person is, the greater their
risk of developing CHD
Smoking is a risk factor of CHD
A person who stops smoking will lower
their risk of developing CHD
High Blood pressure is a risk factor for
developing CHD
Keeping blood pressure under control will
reduce a person’s risk for developing
CHD
High Cholesterol is a risk factor for
developing CHD
Eating fatty foods does not affect blood
cholesterol levels
If your ‘good’ cholesterol (HDL) is high,
you at risk for heart disease
If your ‘bad’ cholesterol (LDL) is high,
you at risk for heart disease
Being overweight increase person’s risk
of CHD
Regular physical activity will lower the
risk of developing heart disease
Only exercising at gym or in an exercise
class lowers the risk factor of developing
heart disease
Walking and gardening are considered
exercise that will help lower risk factor of
developing heart disease
326 (84.9)
Diabetes is a risk factor for developing
CHD
170 (44.3)
High blood sugar make the heart work
harder
236 (61.5)
A person who has diabetes can reduce
their risk of developing CHD if they keep
their blood sugar levels under control
244 (63.0)
Abdominal obesity is a risk factor for
developing CHD
244 (63.5)
Stress may cause increase in blood sugar,
blood pressure, and cholesterol levels
344 (89.6)
Slow deep breath, counting to 10 before
speaking and going for a walk are
examples of stressing inhibitors
309 (80.5)
Women higher CHD’s risk factor if
menopause
119 (31.0)
The main risk factors of CHD is high blood
pressure, followed by smoking, high cholesterol
levels, overweight, and diabetes (Peters, 2018). In
Indonesia, the major CHD’s risk factors in men
because of smoking and high blood pressure. But in
women, it is associated with high cholesterol levels,
high blood pressure, and overweight. The high
cholesterol levels became the main risk factors
among both genders (Ghani, 2016). In Aceh
Province, the risk factors of CHD is similar, there
are overweight, smoking behavior, and high
cholesterol levels (Hadil, 2015).
The participants have a high awareness of the
major CHD’s risk factors in Indonesia. Majority of
participants in this study have the right answer to the
following of modifiable CHD risk factors
statements, there are smoking (92.4%), stress
(89.5%), being overweight (86.5%), LDL levels
(81.5%), high cholesterol levels (77.3%), high blood
pressure (76.6%), and central obesity (63.5%). For
the non-modifiable CHD risk factors, most of them
aware about the aged (69.8%) and family history
(52.1%) become the CHD’s risk factor. But must of
them don’t aware about a woman with menopause as
the CHD’s risk factor. Whereas, in Indonesia the
prevalence of CHD more common in aged women
than men (Riskesdas, 2013). The CHD’s risk factors
increased in an elderly woman due to the estrogen
decrease and followed by the increased of lipid
profile (Agrinier, 2010).
Knowledge of Coronary Heart Disease Risk Factors among People in Banda Aceh
213
46.1%
44.3%
53.9%
55.7%
HDL% DIABETES%
TRUE% FALSE%
Figure 1: The high knowledge level of modifiable CHD’s
risk factors.
Figure 2: The low knowledge level of modifiable CHD’s
risk factors.
Figure 3: The knowledge level non-modifiable of CHD’s
risk factors.
Figure 4: The knowledge level of preventive action to
CHD’s risk factors.
Although the participants have sufficient
knowledge of cholesterol as the CHD’s risk factors,
they just aware that high LDL/ ‘bad’ cholesterol
levels as the CHD’s risk factors. Most of them don’t
know about the low HDL/ ‘good’ cholesterol levels
became the CHD’s risk factors. The low level of
HDL is associated as an important factor in
atherosclerosis formation because HDL becomes
atheroprotective which can protect blood vessels
from plaque formation (Alrawi, 2017; Tousoulis,
2018).
In this study, the participants have a low
knowledge of diabetes as CHD’s risk factors.
Although in Indonesia diabetes is one of the main
risk factors for CHD, which is 5.6% in men and
7.7% in women (Ghani, 2016). And the risk factors
of CHD increased 8 times in Indonesian with a
history of diabetes compared to without a history of
diabetes (Hussain, 2016).
4 CONCLUSIONS
The data in this study indicate a low-knowledge
level of CHD’s risk factors among people in Banda
Aceh community. The participants have a deficient
knowledge about some risk factors of CHD such as,
diabetes, HDL levels, and menopause in women. On
contrary, they have sufficient knowledge about the
major risk factors of CHD’s among Indonesian such
as smoking, high blood pressure, high cholesterol
levels, and inactivity.
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