Letter to the Editor
Poor knowledge about cardiovascular disease: The patient and their family doctor
Baixo conhecimento sobre a doença cardiovascular: o doente e o seu médico de família
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"filipeprazeresmd@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "USF Beira Ria, Gafanha da Nazaré, Portugal" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Faculdade de Ciências da Saúde, Universidade da Beira Interior, Covilhã, Portugal" "etiqueta" => "b" "identificador" => "aff0010" ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Baixo conhecimento sobre a doença cardiovascular: o doente e o seu médico de família" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Despite the disappointing results of the study recently published in the <span class="elsevierStyleItalic">Journal</span> on cardiovascular disease knowledge in Portugal by Andrade et al.,<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">1</span></a> who surveyed 1624 residents of mainland Portugal aged between 16 and 79 years and found important gaps in knowledge about stroke and myocardial infarction, there are important conclusions to be drawn from the study and its accompanying editorial<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">2</span></a> concerning the daily clinical practice of family physicians.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Firstly, those surveyed attributed little importance to controlling blood pressure as a risk factor for cardiovascular disease, despite the high prevalence of hypertension in Portugal. It is known that it is usually family physicians who initiate treatment for hypertension in this country (in 87% of cases) and that they do so in accordance with standards of good clinical practice.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">3</span></a> However, if the results of this survey can be extrapolated to the general population, the message of how to prevent and deal with stroke and myocardial infarction is not getting through to our patients.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Secondly, the editorial<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">2</span></a> accompanying the article clearly describes the need to improve such knowledge (health literacy) to promote health and prevent disease. Since the survey found that respondents with the highest levels of health literacy (as assessed by an instrument designed for use in primary care, the Newest Vital Sign<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">4</span></a>) had the most knowledge about cardiovascular disease, it is tempting to measure health literacy in consultations in order “to know when, where and how to intervene”, as the editorial puts it. However, it should be recalled that in the literature, screening for health literacy in a clinical context is not recommended, as its disadvantages may outweigh its advantages.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">5</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Thirdly, to avoid the feelings of shame and alienation induced through clinical screening,<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">5</span></a> during consultations family physicians can look for certain indirect signs of low health literacy: when questioned, patients may provide an incomplete medical history; often miss appointments and/or make errors regarding their medication; identify their medication by color, size, and shape; and may avoid situations where complex learning is required.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">6</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Finally, there are some simple methods that can be used to assess health literacy that can replace more complex screening tests and are not disruptive during primary health care consultations. These include asking the simple questions “How often do you need to have someone help you when you read instructions, pamphlets, or other written material from your doctor or pharmacy?”<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">7</span></a> and/or “How confident are you filling out medical forms by yourself?”<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">8</span></a></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0030" class="elsevierStylePara elsevierViewall">The author has no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Prazeres F. Baixo conhecimento sobre a doença cardiovascular: o doente e o seu médico de família. Rev Port Cardiol. 2019;38:167–168.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:8 [ 0 => array:3 [ "identificador" => "bib0045" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Knowledge about cardiovascular disease in Portugal" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "N. Andrade" 1 => "E. Alves" 2 => "A.R. Costa" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.repc.2017.10.017" "Revista" => array:6 [ "tituloSerie" => "Rev Port Cardiol" "fecha" => "2018" "volumen" => "37" "paginaInicial" => "669" "paginaFinal" => "677" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30055948" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0050" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Health literacy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "V. 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| 2023 April | 19 | 7 | 26 |
| 2023 March | 38 | 16 | 54 |
| 2023 February | 36 | 22 | 58 |
| 2023 January | 18 | 16 | 34 |
| 2022 December | 40 | 26 | 66 |
| 2022 November | 39 | 36 | 75 |
| 2022 October | 42 | 20 | 62 |
| 2022 September | 27 | 41 | 68 |
| 2022 August | 38 | 32 | 70 |
| 2022 July | 24 | 34 | 58 |
| 2022 June | 22 | 27 | 49 |
| 2022 May | 25 | 26 | 51 |
| 2022 April | 25 | 25 | 50 |
| 2022 March | 39 | 41 | 80 |
| 2022 February | 26 | 39 | 65 |
| 2022 January | 32 | 28 | 60 |
| 2021 December | 22 | 27 | 49 |
| 2021 November | 27 | 36 | 63 |
| 2021 October | 30 | 37 | 67 |
| 2021 September | 19 | 22 | 41 |
| 2021 August | 16 | 24 | 40 |
| 2021 July | 18 | 16 | 34 |
| 2021 June | 16 | 14 | 30 |
| 2021 May | 35 | 39 | 74 |
| 2021 April | 45 | 25 | 70 |
| 2021 March | 26 | 21 | 47 |
| 2021 February | 36 | 10 | 46 |
| 2021 January | 29 | 11 | 40 |
| 2020 December | 25 | 10 | 35 |
| 2020 November | 18 | 10 | 28 |
| 2020 October | 13 | 9 | 22 |
| 2020 September | 14 | 9 | 23 |
| 2020 August | 7 | 6 | 13 |
| 2020 July | 13 | 12 | 25 |
| 2020 June | 13 | 14 | 27 |
| 2020 May | 15 | 3 | 18 |
| 2020 April | 11 | 15 | 26 |
| 2020 March | 17 | 10 | 27 |
| 2020 February | 33 | 26 | 59 |
| 2020 January | 14 | 4 | 18 |
| 2019 December | 9 | 4 | 13 |
| 2019 November | 9 | 7 | 16 |
| 2019 October | 12 | 4 | 16 |
| 2019 September | 13 | 7 | 20 |
| 2019 August | 8 | 7 | 15 |
| 2019 July | 13 | 6 | 19 |
| 2019 June | 21 | 24 | 45 |
| 2019 May | 26 | 14 | 40 |
| 2019 April | 30 | 13 | 43 |
| 2019 March | 12 | 18 | 30 |
Show all
