Sex differences in cardiovascular disease knowledge, risk perception, and preventive care prior to first myocardial infarction

AIMS: This study aimed to investigate sex differences in cardiovascular disease knowledge, risk perception, and preventive care prior to first myocardial infarction (MI). METHODS: The study adopted a cross-sectional design. Using a web-based solution, 1628 Norwegian individuals who experienced a first-ever MI in 2024, mean (SD) age 64.1 (10.0) years, of which 25.4% women, completed the Norwegian ABCD Risk Questionnaire along with a de novo questionnaire. Sex differences were tested using linear regression for total scale scores, logistic regression for binary variables, and ordinal logistic regression for categorical variables. RESULTS: On the ABCD Risk Questionnaire, women scored lower than men on risk perception (B = -0.50, 95% CI = -0.87 to -0.13) and higher on healthy eating attitude (B = 0.68, 95% CI = 0.34 to 1.02). On the de novo questionnaire, MI knowledge was low in both women and men, but women could identify significantly more MI risk factors (B = 0.52, 95% CI = 0.02 to 1.01) and symptoms (B = 1.20, 95% CI = 0.88 to 1.51) than men. Women were less likely than men to report previous MI risk assessment, including smoking status (OR = 0.54, 95% CI = 0.41 to 0.71). Women were also less likely than men to report receipt of lifestyle advice to prevent MI (OR = 2.29, 95% CI = 1.71 to 3.06). CONCLUSION: Cardiovascular knowledge and risk perception were poor among Norwegian individuals prior to MI, with indication that women had better knowledge but poorer risk perception than men. Substantial gaps in self-reported preventive care were identified, particularly among women. Sex-specific strategies are spoken for to improve cardiovascular awareness at both individual and clinical level.