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Knowledge of risk factors for Cardiovascular Disea=
ses
by university students: scientific evidence
Conhecimen=
to
dos fatores de risco de Doenças Cardiovasculares por estudantes universitár=
ios:
evidências científicas
Braima Embaló<=
/span>[1]
* Davide Carlos Joaquim[2]
* Mama Saliu
Culubali[3]
* Virgínia
Cláudia Carneiro Girão[4]
* Daniel Freire de Sousa[5]
* Ana Caroline Rocha de Melo Leite[6]
Objective: To
identify and assess scientific evidence regarding university students’
knowledge about risk factors for Cardiovascular Diseases (CVD). Method=
b>:
This is an integrative review, carried out in 2020, in the MEDLINE, CINAHL,
PubMed, Scopus, and Web of Science databases. Based on the guiding question,
the search for articles took place using the descriptors “Students”,
“Universities”, “Knowledge”, “Cardiovascular Diseases”, and “Risk Factors” =
and
their correspondents in English. Results: Of the 17 articles included, six were availa=
ble
from Scopus, and all were in English. It was observed that students have a =
low
level of knowledge about risk factors for CVD and do not recognize their
vulnerability to them, in addition to not adopting preventive measures and a
healthy lifestyle. Publications suggested the need for health professionals=
in
educational settings to improve knowledge related to health, incorporate
healthy lifestyle practices, and develop strategies to reduce CVD risk leve=
ls. =
Conclusion: The deepening of knowledge and a critical lo=
ok
at the literature showed a lack in the production of Brazilian studies on t=
he
subject, awakening the need to conduct more research and literature reviews=
to
strengthen evidence-based practice.
Keywo=
rds: Students; Universities; Cardiovascular Diseases; =
Risk
Factors; Knowledge.=
RESUMO: <=
span
style=3D'mso-bookmark:_Hlk83372199'>
Objetivo: Identificar e avaliar as evidências científic= as em relação ao conhecimento de estudantes universitários sobre os fatores de risco de Doenças Cardiovasculares (DCV). Método: Trata-se de revisão integrativa, realizada em 2020, nas bases de dados MEDLINE, CINAHL, PubMed, Scopus e Web of Science. Baseado na pergunta norteadora, foi feita a busca = dos artigos, utilizando-se descritores “Estudantes”, “Universidades”, “Conhecim= ento”, “Doenças cardiovasculares” e “Fatores de riscos” e seus correspondentes em inglês. Resultados: Dos 17 artigos incluídos, 6 estavam disponíveis = no Scopus e todos estavam em língua inglesa. Observou-se que estudantes tinham= baixos níveis de conhecimento sobre os fatores de r= isco de DCV e não reconheciam a vulnerabilidade a elas, além de nã= o adotarem medidas preventivas e um estilo de vida saudável. As publicações sugeriram a necessidade de profissionais de saúde em ambientes educacionais, visando ap= rimorar o conhecimento relacionado à saúde, incorporar práticas de estilo de vida saudáveis e desenvolver estratégias de redução dos níveis de risco de DCV. = Conclusão: O aprofundamento do conhecimento e o olhar crítico sobre a literatura apont= aram carência na produção de estudos brasileiros sobre a temática, despertando a= necessidade de condução de mais pesquisas e revisões da literatura para fortalecimento = da prática baseada em evidências.
Palavras-chave: Estudantes (Estudiantes); Universidades (Universidades);=
Doenças
Cardiovasculares (Enfermedades Cardiovasculares=
);
Fatores de Risco (Factores de Riesgo); Knowledg=
e.
INTRODUCTION
=
In the current context,=
Non-Communicable
Chronic Diseases (NCCDs), such as Cardiovascular Diseases (CVD), diabetes,
cancer, and chronic respiratory diseases1, represent a serious
problem for global public health, as a consequence of the high number of de=
aths
and disabilities2 observed in developed and underdeveloped count=
ries3.
In fact, NCCDs are responsible for the death of 41 million people per year,=
a
figure that corresponds to 71% of all deaths4. In etiopathogenic terms, they result from the action of
genetic, physiological, environmental, and lifestyle factors4.
=
Defined as a group of
disorders that affect the heart and arterial and venous circulation5,6=
,
which includes coronary artery and cerebrovascular disease and aortic
atherosclerosis7, CVD represents the leading cause of death in t=
he
world8. Indeed, this condition is responsible for 30% of the 50
million deaths recorded worldwide in recent decades9. Its etiolo=
gy,
although it involves factors considered non-modifiable, such as gender, age,
family history, and ethnicity, also comprises modifiable or avoidable eleme=
nts,
such as sedentary lifestyle, obesity, Systemic Arterial Hypertension (SAH),
Diabetes Mellitus (DM), dyslipidemia, smoking, inadequate diet, and alcohol
intake10,11.
=
Although it affects mai=
nly
adults over 60 years old6, in addition to the occurrence in
individuals under 40 years of age, usually associated with genetic conditio=
ns12,
the literature shows the increased prevalence of risk factors for CVD among
young adults, represented especially by obesity and sedentary lifestyle13.
In particular, the greater occurrence of CVD in younger age groups may be
related to the perception that these diseases only occur in older individua=
ls14,15.
The dietary changes experienced by this public as a consequence of the
urbanization process and easy access to processed foods also contribute to =
this
reality16.
=
Faced with this new
scenario, university students stand out as a vulnerable group for CVD,
especially considering their sedentary behavior17,18, alcohol and
cigarette consumption19, stress20, and alteration of
eating habits21. Corroborating this assumption, studies report t=
he
presence of CVD risk factors among students from different courses, such as
Medicine22, Nursing23, Nutrition, and Physiotherapy24.
=
In this sense, the
literature emphasizes that enrollment in University favors the contact with=
and
development of CVD risk factors by students, especially those who are force=
d to
distance themselves from family and take responsibility for their housing, =
food,
and financial conditions23,25. With the progression of their stu=
dies,
other factors are added, such as the extensive workload in the classroom and
internships, adoption of consumption of industrialized foods due to the
scarcity of time and money, limited access to healthy foods in the universi=
ty
environment, and reduced availability and time to exercise23,25,26.
=
Despite the presence of
these risk factors among university students, studies reveal a lack of
knowledge of these factors among these students, which can interfere with t=
heir
health status. In this sense, according to Rezende et al.27,
the assessment of the levels of knowledge and identification of risk factor=
s is
paramount for health promotion in the context of CVD, especially for the
academic community, which is often a reference for society.
=
Thus, considering the
above, this study aimed to identify and evaluate scientific evidence regard=
ing
the knowledge of university students about CVD risk factors.
METHODS
=
It consists of an
integrative review of the literature, which aims to identify, describe, gat=
her
and synthesize results of studies. When it is well developed, it enables th=
e integration
of research on a given subject, fostering the development and direction of
other investigations, assisting in decision making and allowing the
incorporation of evidence in clinical practice28.
=
Based on Sousa et al=
.29,
this review was elaborated in six stages, namely: identification of the the=
me and
objectives of the integrative review; formulation of the guiding question;
search in the literature and careful selection of studies; categorization of
the studies found and analysis of the publications included; interpretation=
of
the results; report of the review and synthesis of the knowledge evidenced =
in
the studies.
=
For the formulation of =
the
guiding question, the PICO strategy was used, which represents an acronym
meaning “patient, intervention, comparison and outcome”. These four compone=
nts are
fundamental to the research issue and the construction of the guiding quest=
ion,
particularly when studying a very specific topic29.
=
Based on this strategy,=
this
review considered “P” university students, “I” and “C” were not applied and=
“O”
knowledge about cardiovascular diseases risk factors. In order to answer the
objective of the study, the following guiding question was defined: “What do
university students know about the risk factors for cardiovascular diseases=
?”.
For the search of the articles, we used the controlled descriptors in
Portuguese “Estudantes”, “=
Universidades”,
“Conhecimento”, “Doenças=
span> cardiovasculares” and “Fatores=
span> de
riscos”, indexed in the descriptors in Health
Sciences (DeCS), and their respective correspondents in English “Students”,=
“Universities”,
“Knowledge”, “Cardiovascular diseases” and “Risk factors”. All words were
combined together and associated through the Boolean operator “AND”.
=
The search and analysis=
of
the articles were carried out during the months of February and March 2020,=
through
the Journal Portal of the Coordination for the Improvement of Higher Educat=
ion
Personnel (CAPES)/Ministry of Education (MEC), using the following database=
s: Medical
Literature Analysis and Retrieval System Online (MEDLINE); Cumulative
Index to Nursing and Allied Health Literature (CINAHL); National Lib=
rary
of Medicine (PubMed); Scopus – multidisciplinary basis; and Web of
Science.
=
We included in the revi=
ew full
articles, available for free, published in the last 10 years (2010 to 2020 =
– this
time frame was based on the possibility of including a larger number of stu=
dies
addressing the theme), in Portuguese, English and Spanish. We excluded repe=
ated
articles, editorials, letters to the editor, theses, dissertations, review =
articles,
reports, and articles not related to the theme or not relevant to this revi=
ew.
=
After collection, the d=
ata
were organized based on the tool adapted from Ursi30, consisting=
of
a specific Check List model, divided into nine domains, whose objective is =
to
facilitate the description and publication of the data present in articles<=
sup>31.
These were primarily organized according to: article title; authors, journal
and publishing field; place where the research was conducted and year in wh=
ich
it was published; and database in which it was indexed. Subsequently, we
examined the objective, type of study and evidence level and, later, the
results and conclusion.
=
The analysis of the
classification of the articles’ evidence was based on the proposal by Still=
well
et al.32. These authors categorize the research evidence =
into
seven levels, in which the first corresponds to the best external evidence,
presenting more reliable information, and the latter comprises information =
with
a lower degree of reliability.
RESULTS
=
Through that search str=
ategy,
we found 262 papers, out of which 191 had been published in the last 10 yea=
rs. Among
these, 93 were in English, Spanish or Portuguese and, within those, 71 were
available in full. After reading the title and abstract of the 71 publicati=
ons,
42 were excluded because they were not related to the objective of the revi=
ew.
Of the 29 articles read in full, 9 were excluded for duplicity and 3 because
they did not meet the inclusion criteria. Thus, 17 publications comprised t=
he
review (Figure 1).
=
Figure 1= – Flowc= hart identifying the study selection process to make up the integrative review.<= /span> Redenção - CE, Brazil, 2020<= o:p>
=
Source: The autho=
rs
=
=
Out of all articles
included, 5 were available on Scopus and all were in English. As for the ye=
ar
of publication, 3 were published in 2012, a quantitative equal to that obse=
rved
in the years 2015, 2017 and 2019.
=
Regarding the place whe=
re the
study was carried out, 3 were conducted in Turkey, a number equal to that f=
ound
in the United States of America. Concerning the publishing field, 11 studies
were developed in the field of Medicine (Table 1).
Table 1
– Characterization of the publications included in the review, according to=
title,
authors, year, journal, field, country, and database. =
Redenção
- CE, Brazil, 2020.
N. |
Article title |
Author and year |
Journal and field |
Country |
Database |
01 |
Knowledge, attitude, and practice on salt =
and
assessment of dietary salt and fat intake among University of Sharjah
Students |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>Ismael et al. 2019 |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Journal Nutrients <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'> <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Nutrition |
<= span lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri= f; mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>United Arab Emirates<= o:p> |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>Scopus |
02 |
Cardiovascular risk factors among lower
Silesian students of the Faculty of Medicine: knowledge and distribution |
<=
span
class=3DSpellE>Kalka et al. <=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>2016 |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Adv Clin Exp Med <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'> <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Medicine |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>South and Southeast
Poland |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>Scopus |
03 |
Knowledge, attitude, and practice of Malay=
sian
Public University students on risk factors for cardiovascular diseases |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Ibrahim et al. <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>2016 |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Journal of Applied
Pharmaceutical Science <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'> <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Medicine |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>Malaysia |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>Scopus |
04 |
Prevalence of obesity and hypertension amo=
ng
University students’ and their knowledge and attitude towards risk factor=
s of
Cardiovascular Disease (CVD) in Jeddah, Saudi Arabia |
<=
span
class=3DSpellE>Baig <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>2015 |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Pak J Med Sci <=
i> <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Medicine |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>Saudi Arabia |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>Scopus |
05 |
Diabetes Mellitus-related knowledge among
University students in Ajman, United Arab Emirates |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Khan et al. <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>2012 |
<= span lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri= f; mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>SQU Medical Journal <= o:p> <=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'> <=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>Medicine |
<= span lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri= f; mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>United Arab Emirates<= o:p> |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>Scopus |
06 |
Awareness of cardiovascular risk factors a=
mong
University students in Turkey |
<=
span
class=3DSpellE>Güneş et al. <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>2019 |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Primary Health Care
Research & Development <=
i> <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Medicine |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Turkey |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>PubMed |
07 |
Prevalence, risk awareness and health beli=
efs
of behavioral risk factors for cardiovascular disease among University
students in nine ASEAN countries |
<= span class=3DSpellE>Peltzer et al. <= o:p> <=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>2018 |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>BMC Public Health <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'> <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Pharmacy |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Nine countries in the
ASEAN* |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>PubMed |
08 |
Assessment of knowledge of critical
cardiovascular risk indicators among college students: does stage of
education matter? |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Sarpong et al. <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>2017 |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Int. J. Environ. Res.
Public Health <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Nursing |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>United States of America |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>PubMed |
09 |
The perception and knowledge of cardiovasc=
ular
risk factors among Medical students |
<=
span
class=3DSpellE>Reiner et al. <=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>2012 |
<=
span
class=3DSpellE>Meoica'l Education- Croat Med=
J. <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'> <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Medicine |
<=
span
class=3DSpellE>Croatia |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>Medline |
10 |
Cardiovascular health risk behavior among
Medical students in a teaching hospital |
<=
span
class=3DSpellE>Giri <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>2012 |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>J Nepal Health Res <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'> <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Medicine |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>Nepal <=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'> |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>Medline |
11 |
Awareness and knowledge of cardiovascular
disease risk factors among Medical students |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>et al. <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>2017 |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Wien Klin
Wochenschr <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'> <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Medicine |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Serbia |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>Medline |
12 |
An experiential cardiovascular health
education program for African American college students |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Holland et al. 2014 |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>The ABNF Journal <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'> <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Medicine |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>United States of Amer=
ica |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>Web of Science |
13 |
Cardiovascular disease risk factors and
knowledge level in Nursing students |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Kaya et al. <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>2019 |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Clin Exp Health Sci <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'> <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Nursing |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Turkey |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>Web of Science |
14 |
Factors predicting nutrition and physical
activity behaviors due to cardiovascular disease in Tehran University
students: application of health belief model |
<=
span
class=3DSpellE>Najarkolaei et al. <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>2015 |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Iran Red Crescent Med=
J <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'> <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Medicine |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Tehran |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>Web of Science |
15 |
Knowledge, attitude and behaviour
regarding dietary salt intake among Medical students in Angola |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>Magalhães et al. <=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>2015 |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Cardiovascular Journa=
l of
Africa <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'> <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Medicine |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>Angola |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>Web of Science |
16 |
University students’ knowledge levels about
cardiovascular risk factors and assessment of their health behaviours in Turkey |
<=
span
class=3DSpellE>Kes et al. <=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>2018 |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Journal of American
College Health <=
i> <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Nursing |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Turkey <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'> |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>CINAHL |
17 |
Cardiovascular risk factors among college =
students:
knowledge, perception, and risk assessment |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Tran et al. <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>2017 |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>International Journal=
of
Caring Sciences <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'> <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Nursing |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>United States of Amer=
ica <=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'> |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>CINAHL |
*ASEAN - Association
of Southeast Asian Nations.
Source: The authors
=
Concerning the objectiv=
es
of the studies, they mainly involved evaluating the knowledge, attitudes, a=
nd
practices regarding CVD risk factors by university students. Other objectiv=
es
mentioned were: - to study the prevalence of obesity and hypertension among
university students; - to investigate the knowledge and practices related t=
o DM
by these students; - to determine the prevalence of CVD risk factors in this
public; - to assess the impact of medical education on knowledge and acknow=
ledgment
of the importance of implementing preventive measures against CVD, accordin=
g to
the perception of medical students; - to know the results of the risk
assessment of CVD among university students; - to identify the important
predictors of nutrition and physical activity in relation to CVD in these
students (Table 2).
=
Regarding the methodological design, 16 articles were descriptive
studies, and, on the evidence level, all publications presented level VI.
Table 2 – Characterization of the publications incl=
uded
in this review, according to objective, type of study, and level of evidenc=
e. Redenção - CE, Brazil=
span>,
2020.
N. |
Objective |
Type of study |
Evidence level |
01 |
To investigate the knowledge, attitudes, a=
nd
practices related to the presence of salt in the diet of UOSa
students and to evaluate the ingestion of total, saturated and trans
fats, cholesterol, and sodium |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Descriptive |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>VI |
02 |
To evaluate medical students’ knowledge ab=
out CVDb risk factors and their prevalence i=
n the
population researched |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Descriptive |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>VI |
03 |
To measure and evaluate the knowledge,
attitudes, and practices of university students concerning CVDb risk factors |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Descriptive |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>VI |
04 |
To investigate the prevalence of obesity a=
nd
hypertension among university students and their knowledge and attitudes
regarding CVDb risk factors |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Descriptive |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>VI |
05 |
To evaluate university students’ knowledge=
and
practices regarding DMc, including=
the
differences related to gender and family history |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Descriptive |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>VI |
06 |
To determine the awareness level of univer=
sity
students, especially freshmen, in terms of CVDb=
risk factors (high cholesterol, stress, hypertension, smoking, obesity,
diabetes, physical inactivity, family history of CVD=
b,
unhealthy diet, exposition to passive smoking, and low socioeconomic leve=
l) |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Descriptive |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>VI |
07 |
To investigate the prevalence, awareness, =
and
health beliefs related to CVDb risk
factors among university students in nine countries in the ASEANd |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Descriptive |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>VI |
08 |
To estimate and compare the awareness leve=
l of
students in the 1st professional year in the Pharmacy course a=
nd
university students in the 2nd semester of the same course abo=
ut
their numbers (cholesterol, arterial pressure, blood sugar, and BMIe) |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Descriptive |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>VI |
09 |
To evaluate the perceptions, knowledge, and
awareness regarding CVDb risk fact=
ors
among medical students |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Descriptive |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>VI |
10 |
To evaluate health behavior and the percep=
tion
of medical students related to cardiovascular diseases |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Descriptive |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>VI |
11 |
To evaluate the knowledge and attitude of
medical students related to CVDb r=
isk
factors and to evaluate the impact of medical education in the knowledge =
and
acknowledgement of the importance of implementing preventive measures of
these diseases for these students |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Descriptive |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>VI |
12 |
To investigate the application of a cultur=
ally
specific test and a curriculum developed for African American university
students in order to increase awareness about the risk of CVDb |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Descriptive and mixed=
|
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>VI |
13 |
To determine the knowledge about CVDb risk factors and the evaluation of =
risk
among Nursing students |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Descriptive |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>VI |
14 |
To identify important predictors in nutrit=
ion
and physical activity related to CVDb in
university students in Tehran |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Descriptive |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>VI |
15 |
To determine the ingestion of salt and to
evaluate the knowledge, attitude, and behaviors related to that ingestion
among medical students |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Descriptive |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>VI |
16 |
To evaluate the knowledge levels of univer=
sity
students about CVDb risk factors a=
nd
their health behaviors |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Descriptive |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>VI |
17 |
To evaluate the knowledge and perceptions =
of
university students about CVDb risk
factors and to identify these risks |
<=
span
lang=3DEN-US style=3D'font-size:12.0pt;font-family:"Times New Roman",seri=
f;
mso-bidi-font-family:Arial;mso-ansi-language:EN-US'>Descriptive |
<=
span
style=3D'font-size:12.0pt;font-family:"Times New Roman",serif;mso-bidi-fo=
nt-family:
Arial'>VI |
aUniversity of Sharjah (UOS); bCardiovascular diseases; cDiabetes
Mellitus; dAssociation of Southeast =
Asian
Nations; eBody Mass Index.
Source: The autho=
rs
=
Regarding the results
observed in the articles, they emphasized that, despite the differences bet=
ween
university students from different colleges and course time, in general,
students had low levels of knowledge about CVD risk factors. Among these
factors, were mentioned physical inactivity, high-fat diet, smoking, obesit=
y,
genetic factors, hypertension, and type 2 DM. The studies also pointed out =
the
presence of risk factors among students, such as overweight, obesity,
hypertension, excessive intake of fats and sodium, lack of physical activit=
y,
alcohol intake, and smoking (Table 3).
=
Some studies also found
that, despite the students’ awareness of CVD risk factors, they did not see
themselves at risk of developing these diseases, did not adopt preventive
measures and did not have a healthy lifestyle practice. Other authors also
showed a low level of knowledge about health indicators among university
students, the perception that the Medicine course was harmful to health and
differences between genders regarding attitudes and practices in health.
=
Regarding the conclusio=
n,
the articles, in general, concluded that university students had an
insufficient level of awareness and knowledge about CVD risk factors, as we=
ll
as high prevalence of these factors among them. The studies also suggested =
the
need for the presence of health professionals in educational environments, =
in
order to improve health-related knowledge, incorporate healthy lifestyle
practices and develop strategies to reduce CVD risk levels among students.<=
span
style=3D'mso-spacerun:yes'>
=
Table 3 – Characterization of the publications incl=
uded
in this review, according to results and conclusion. Redenção - CE, Brazil,
2020.
N. |
Results |
Conclusion |
01 |
Among the students, the results indicated a
low knowledge score regarding the presence of salt in the diet, as well a=
s a
high prevalence of overweight (28%), obesity (14%), and stage 1 (31%) and=
2
(20%) hypertension. A high percentage of students who exceeded the
recommended intake of total fat (48%), saturated fat (90%) and trans-fat
(64%), and sodium (89%) was observed. All students did not meet the adequ=
ate
recommended potassium intake |
Knowledge, attitudes and practices related to
salt consumption among students revealed the non-recommended intake of to=
tal,
trans and saturated fat, and sodium. This result highlights the need to
develop specific awareness campaigns regarding the culture of salt and fat
intake and its association with health |
02 |
The students correctly identified five risk
factors for CVDa, among which the =
most
cited were lack of physical activity and high-fat diet, followed by smoki=
ng,
obesity, genetic factors, and hypertension. The results showed that there=
is
a relatively healthy awareness on the part of students regarding risk fac=
tors
for CVDa. However, there was no
correlation with a healthy lifestyle |
The study revealed an insufficient level of
awareness of the CVDa risk factors=
among
medical students |
03 |
Among university students from different
colleges, significant differences were found in relation to knowledge of =
CVDa risk factors (=
SAHb,
DMc, sedentary lifestyle, heredity,
stress, smoking, unhealthy diet, and lack of physical exercise), as well =
as
differences in attitude and practice between the genders. The data indica=
ted
that the practice of healthy lifestyle was not adequate among the
participants |
The study suggests that students should
increase health practice for the prevention of CVD |
04 |
The results indicated that 7.5% of the
participants were hypertensive, 29.8% were overweight, 10.7% were moderat=
ely
obese, and 7.9% were severely obese. Most participants were aware th=
at a
healthy lifestyle could prevent CVDa,
although they did not practice it |
There is a large gap in knowledge, attitude, =
and
practice among the young Saudi university population in relation to the r=
isk
factors of CVDa |
05 |
Of the participants, 25% were overweight or obese and only 27% exercised regularly.=
About DMc=
, 70% of the students knew that the disease was characterized by the presence of high blood sugar levels and that family history=
was an important=
risk factor. More than half of those surveyed linked=
obesity and physical=
inactivity to risk factors for DMc=
|
Despite exposure to various sources of inform=
ation,
the level of students’ knowledge about DMc
is inadequate. It is recommended that health professionals engage in
educational environments in order to improve health-related knowledge and
incorporate healthy lifestyle practices among students |
06 |
The study revealed that male students are less
aware of the risk factors for CVDa=
(high
cholesterol, stress, hypertension, smoking, obesity, diabetes, physical
inactivity, and others) than female students. Comparations between the |
The observations indicated that the levels of
awareness of CVDa risk factors nee=
d to
be improved among university students. Therefore, it is extremely importa=
nt
that primary care health professionals develop interventions to reduce ri=
sk
levels of CVDa |
07 |
In all nine ASEANe<=
/sup>
countries, there was a prevalence of CVDa=
risk factors among students. For the five risk factors considered (smokin=
g,
unhealthy diet, obesity, physical inactivity, and harmful alcohol use),
students’ awareness of the involvement of these factors in CVDa was low. However, the female studen=
ts
presented lower prevalence of these factors and a “healthier” belief when
compared to male students, except in exercising |
The research found a high prevalence of
behavioral risk factors for CVDa,
limited awareness of these risks and negative health beliefs. The results=
may
favor the development of health promotion strategies among university
students of ASEANe. |
08 |
The students’ level of knowledge about the fo=
ur
health indicators (cholesterol, arterial pressure, blood sugar, and BMId) was extremely low. Among the Pharm=
acy students
of the 1st year and freshmen, differences were observed in ter=
ms
of knowledge about total cholesterol and arterial pressure. In both group=
s,
less than 50% of the students knew their BMId=
sup>,
with a higher percentage found among those in the 1st professi=
onal
year. The percentage of correct answers to the other three health indicat=
ors
(cholesterol, blood sugar, and BMId) was
low among students |
The research revealed a low level of awarenes=
s of
students about their health indicators. It also showed that two or more y=
ears
of higher education and the choice of a professional health career make a
difference in the level of students’ awareness about health. However, more
research is needed to understand the low level of awareness of critical
health indicators among students |
09 |
Although insufficient, the perception and
knowledge of some CVDa risk factors
(dyslipidemia, arterial hypertension, and metabolic alterations) were
significantly better among undergraduate students than among freshmen. At=
the
end of medical school, many students were smokers, despite knowing the
harmful effects of smoking. They had a reduced awareness of the contribut=
ion
of obesity in the development of CVDa |
The results suggest an urgent need to raise
awareness among medical students about the importance of obesity and redu=
ced
physical activity in the development of CVDa
|
10 |
Faced with the possibility of developing CVDa, 85 (53%) students showed concern,
although only 33 (38%) had adopted preventive practices (physical activit=
y,
and regular consumption of fat and salt). Of the total number of
participants, 101 (64%) believed that life in medical school had a
detrimental effect on health |
The study showed a high prevalence of risk
behaviors for CVDa among medical
students |
11 |
More advanced students in medical school had
greater knowledge about the risk factors for CVDa
(cholesterol, metabolic syndrome, and lipid-lowering therapy) than those =
who
were at the beginning of the course. Only about 20% of the students knew =
all
the risk factors included in the metabolic syndrome. Factors such as phys=
ical
inactivity, obesity, type 2 DMc, s=
moking,
and hypertension were not considerably classified as important CVDa risk conditions |
The study clearly showed that medical student=
s’
knowledge of the CVDa risk factors
should be improved. Furthermore, medical education should provide basic
knowledge that enables the effective prevention of these diseases |
12 |
Regarding the program, which consisted of wee=
kly
classes, during which occurred experimental activities, self-assessments,
discussions, and homework with African American students, its effectivene=
ss
was verified. Several benefits of the intervention were identified, such =
as
increased knowledge about risk factors for CVDa=
and physical capacity, as well as better eating habits and greater knowle=
dge
about stress management strategies |
Experimental workshops with small groups can =
be
effective for understanding the risks and establishing healthy habits for=
the
prevention of CVDa among African A=
merican
university students |
13 |
The students’ level of knowledge about CVDa risk factors (=
BMId,
arterial pressure, blood sugar, cholesterol, and triglycerides) was low. =
The
percentage of overweight and obese participants was 18.8% for men and 22.=
1%
for women. An inversely proportional relationship was observed between the
higher level of knowledge about the CVDa<=
/span>
risk factors and the reduction in blood sugar and cholesterol values |
The research showed a reduced knowledge of th=
e CVDa risk factors among Nursing students=
, in
addition to the presence of these risk factors |
14 |
It was found that the female students had a
more adequate nutrition. A positive association was observed between
knowledge, perceived severity of CVDa
and self-efficacy with the practice of physical activity, as well as a
negative relationship between this behavior and perceived barriers (fear =
of
strangers, bad weather, and many school tasks) |
The study indicated that the contrasts between
health beliefs can predict the risk behavior of college students in the f=
ace
of heart disease. However, more research is needed to verify the predicto=
rs
of high-risk behaviors in these students |
15 |
Among the students, salt intake was higher th=
an
the internationally recommended maximum limit, although they were aware of
its consequences. Less than half of the participants reported being aware=
of
their high sodium intake. Regarding potassium, the average intake by the
students was lower than the recommended value. In relation to other class=
ical
risk factors for CVDa, a high prev=
alence
of physical inactivity and alcohol intake was observed, as well as a low
prevalence of hypertension, diabetes, and obesity |
The study indicated a high salt intake among
medical students and an inadequate perception of their intake level, as w=
ell
as insufficient attitude and behavior in relation to their control. Given
this scenario, nutritional education is necessary to improve the knowledge
and eating habits of these students |
16 |
Among the students, low levels of knowledge a=
bout
CVDa risk factors (smoking, alcoho=
l,
unhealthy diet, physical inactivity, BMId=
,
and stress) were found. Of the participants, 46.1% were smokers, 31.9%
consumed alcohol, 20.8% were overweight, 1.6% were obese, and 26.1% had
chronic diseases. The results showed that students did not have healthy
behaviors, such as physical exercise, adequate nutrition, and stress cont=
rol |
The evaluations of knowledge levels showed th=
at
the students did not have adequate knowledge and that there was a positive
and significant relationship between positive health behaviors and levels=
of
knowledge about CVDa risk factors.=
In
this sense, it can be suggested that studies and screening in chronic
diseases and regular medical consultations can prevent these diseases |
17 |
Participants knew the CVDa=
span> risk factors (diabetes, overweight/obesity,
hypertension, hyperlipidemia, smoking), but did not perceive themselves a=
s at
risk of developing them. When the CVDa risk factors were evaluated, it was found that more than 50% of the
students had one or more of these factors |
The high level of knowledge of the CVDa risk factors was not sufficient to =
reduce
the risks of these diseases among students. Thus, changing the perception=
of
these factors may play a greater role in reducing the risks of these dise=
ases
in the long term |
aCardiovascular=
span> Diseases; bSystemic Arterial Hypertension; cDiabetes Mellitus; <=
sup>dBody
Mass Index; eAssociation of Southeast
Asian Nations.
Source: The autho=
rs
DISCUSSION
=
The statistics presented in the literature reveal that CVD represents
one of the main causes of death in the global context. Therefore, the relev=
ance
of studying cardiovascular risk factors in university students is based on =
the situation
that this public, due to physical, emotional, and social transformations, s=
eeks
independence and new experiences, associated with a high burden of stress c=
aused
by the university environment, and becomes vulnerable to risk behaviors, ev=
en with
access to information19.
=
Thus, understanding these factors can prevent, maintain, or restore =
the
health of this population and avoid socioeconomic impacts33, sin=
ce
these elements can be modifiable according to the environment and exposure =
time34.
=
In this review, we evaluated the productions that addressed the
prevalence, knowledge, attitudes, and practices in relation to CVD risk fac=
tors
in university students. The verification of these aspects in young adults m=
akes
it possible to identify the susceptibility level of these individuals to th=
ese
diseases. Therefore, the compilation of the studies will help to identify g=
aps
in knowledge, which may improve the practices and policies aimed at the pro=
motion
and prevention of CVD among university students.
=
Evaluating the number of studies included in this review according to
the database, the highlight for Scopus can be understood because it is the
largest database, containing abstracts of peer-reviewed publications, from
Elsevier35. As for the language of the articles included here, t=
he
fact that all are in English can be justified because it is one of the
strategies used for scientific internationalization36 or because
possible databases that include articles in the Portuguese language weren’t
included in the review.
Rega=
rding
the greater number of studies published in different years, this result may
suggest the relevance and interest of the theme portrayed here in different
moments. As for the place of study included in this review, the emphasis on
Turkey, in addition to the USA, was an unexpected data, since China has sto=
od
out for encouraging the development of research37. The prominence of the USA can be justified by the
possibility that this country develops more research in this area as a
consequence of eating habits, lifestyle, and occurrence of cardiovascular
diseases in the population, since it is considered one of the global leader=
s in
science and technology38=
.
Conc=
erning
the field of publication of the articles, the large number of papers availa=
ble
in journals in the medical field, although it evidences the importance of t=
he
theme for Medicine, suggests a deficiency in the integration between the
different health fields, which is in line with what is stated in the
literature. According to Guimarães and Branco39,
health work should involve interdisciplinary, multidisciplinary, and
transdisciplinary actions.
Rega=
rding
the majority of publications presenting, as a methodological design, the
descriptive study, although it describes data that were verified, recorded,
analyzed, classified and interpreted, without the interference of the
researcher and with the use of standardized data collection techniques=
40,
it does not seek to evaluate a possible association between the cause of the
disease and its effect41. On the predominance of studies with ev=
idence
level VI, this finding suggests that the publications do not present strong
evidence, which may impair their clinical applicability32.
When
analyzing the objectives of the articles included, the greater number of
publications that evaluated the knowledge, attitudes, and practices related=
to
CVD risk factors in university students exceeded the expectations of this
review because they were not limited to the knowledge of these factors. This
result is important in the sense that interventions aimed at the promotion =
and
prevention of CVD, of an individual or collective nature, are better perfor=
med
if based on the knowledge of the attitudes and practices of the public to w=
hich
they are intended42.
The =
same can
be said in relation to the studies portrayed here, which proposed to present
the prevalence of risk factors or of CVD itself among university students, =
the
results of the assessment of this risk and the analysis of the impact of
education on knowledge and acknowledgement of the importance of implementing
preventive measures against CVD. Indeed, knowing these different aspects can
interfere in actions aimed at preventing, maintaining, and restoring the he=
alth
of university students in the face of these diseases.
Conc= erning the results presented by the studies included in the review, the fact that, in general, students presented low levels of knowledge about CVD risk factors was surpri= sing, especially considering that this phenomenon occurred among students from different colleges and course time. Also emphasizing how unforeseen this finding is, it is known that these students presented numerous risk behavio= rs for these diseases an= d that the University represents an important means of disseminating information on these risk factors to many yo= ung people43.<= o:p>
However,
this data may result from the way the media and the consumerism of today’s
society link these risk factors to pleasure, especially in fast food
advertisements, in addition to the fact that it is accepted that the conseq=
uences
of behavioral risk factors on health are usually manifested at older ages44.
This data can also re=
sult
from the parents’ education level, especially the mother’s, because of the role that she undertakes in
the care of children45. Indeed, in research by Paulitsch
et al.46, the authors observed that students whose mothers had 5 to 11 years of =
schooling
were more likely to have an additional risk factor compared to those whose
mothers had schooling greater than or equal to 12 years.
Thus,
regardless of the cause of misinformation, its consequence may not decrease=
the
incidence of CVD among university students, in addition to promoting the
increase in costs for the public and private sectors47.
Regarding
CVD risk factors, the literature classifies them into modifiable risk facto=
rs
(environmental and behavioral), such as smoking, alcoholism, high cholester=
ol,
systemic arterial hypertension, physical inactivity, stress, and secondary =
conditions
(DM, obesity, contraceptive use, and abdominal obesity), and non-modifiable
risk factors (genetic and biological), represented by heredity, gender, and
advanced age44.
Specifically,
the risk factors for CVD reported in the studies included here were numerous
and comprised both modifiable and non-modifiable factors, with a higher num=
ber
among the former. These factors were also observed by other authors44,=
48,
who highlighted sedentary lifestyle. The latter, together with hypertension,
smoking, hyperglycemia, and overweight/obesity, is one of the globally known
CVD risk factors49.
In
this review, smoking was the modifiable risk factor most cited by students,
which may be associated with the high practice of this habit among universi=
ty
students50 and/or the fact that it is one of the main modifiable=
cardiovascular
risk factors51. According to the literature, smoking is responsi=
ble
for numerous and diverse chronic diseases and for half of all preventable
deaths50. It is considered responsible for the increase of oxida=
tive
stress, inflammatory process, and endothelial and platelet dysfunction,
phenomena that can cause damage to the body51.
Concerning
the result presented by the articles that, despite being aware of the risk
factors of CVD, students did not believe in their vulnerability to these di=
seases,
it can be understood if it is assumed that the age above 45 years for men a=
nd
55 years for women is considered as a susceptibility factor to CVD52=
sup>.
As for the non-adoption of preventive measures by students, this result may=
be
associated with the very belief that they are not susceptible to CVD and/or=
with
lack of time53. As for the lack of practice of a healthy lifesty=
le,
despite the awareness of risk factors, it can be explained by problems in t=
ime
administration, the need to perform well53, impairment of eating
habits and mealtimes, and adoption of a more sedentary lifestyle54.
Regarding
the low level of knowledge about health indicators among university student=
s,
this finding is worrisome because it suggests that these students are unawa=
re
of the reality experienced by them, which may compromise the application of
policies and strategies aimed at good action and performance of the health
system, as well as the monitoring of these diseases in this population.
Concerning
the perception of university students that the Medicine course was harmful =
to their
health, this result corroborates Stegers-Jager =
et al.55,
who reported that the challenge of medical schools is to provide academic
environments that do not compromise health and stimulate progress in studie=
s.
Specifically, the chronic stress experienced by these students may increase=
the
risk of cardiometabolic and neurodegenerative diseases, in addition to caus=
ing
cognitive decline and adverse effects in the hippocampus55.
This
data can also be understood if we admit that medical students present, in
general, an inadequate lifestyle marked by sedentarism, inadequate eating
habits, limited time for leisure, and high workload, as well as high freque=
ncy
of tests and expectations of themselves, social isolation, competition with
friends, and excessive subjects to study56,57.
As for
the differences between genders regarding the health attitudes and practice=
s of
university students observed by the studies discussed here, this result see=
ms
to reflect the stereotypes related to gender, especially expressing the ima=
ge
of the man as the one who is stronger, who does not take care of himself or
others and who does not seek health services. On the other hand, the woman =
is
the one who is naturally a caregiver and who requires more attention due to=
the
particularities of the female organism58. This data is worrisome,
since men seem to be more vulnerable to chronic and severe illnesses, in
addition to having an earlier death59,60.
CONCLUSIONS
=
The data in the review enabled us to deepen the
knowledge and critical look about what is produced by the national and
international literature on the theme portrayed here. In this context, few
Brazilian studies were included, which alerts us to the need to conduct more
research related to the knowledge of cardiovascular disease risk factors am=
ong
university students, fostering the elaboration of new literature reviews and
strengthening evidence-based practice.
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/view/3874
Corresponding=
author
Ana Ca=
roline
Rocha de Melo Leite.
Universidade da Integração Internacional da
Lusofonia Afr=
o-Brasiliera
- Campus das
Auroras - Rua José Franco de Olive=
ira,
s/n,
CEP – 62.790-970 – Redenção-Ceará,=
fone
(85) 99168-0679 e e-mail:
=
acarolmelo@unilab.edu.br
Submission: 2021-05-25
Approval 2021-09-26
[1]=
Enfermeiro pela
Universidade da Integração Internacional da Lusofonia Afro-Brasileira – UNILAB. Redenção - CE,
Brasil. ORCID https://orcid.org/0000-0002-7787-1889
[2]=
Enfermeiro pela
Universidade da Integração Internacional da Lusofonia Afro-Brasileira – UNILAB. Doutorando do
Programa de Pós-graduação em Ciências Morfofuncionais da Universidade Feder=
al
do Ceará – UFC. Mestre pelo Programa de Pós-Graduação em Enfermagem da UNIL=
AB.
Redenção - CE, Brasil. ORCID https://orcid.org/0000-0003=
-0245-3110
[3]=
Enfermeiro pela
Universidade da Integração Internacional da Lusofonia Afro-Brasileira – UNILAB. Redenção - CE,
Brasil. ORCID https://orcid.org/0000-0002-8079-866X
[4]=
Médica Veterinária pela
Universidade Estadual do Ceará – UECE. Doutora em Farmacologia pela
Universidade Federal do Ceará – UFC. Mestre em Ciências Veterinárias pela U=
ECE.
Docente do Departamento de Morfologia da UFC. Fortaleza, Ceará – Brasil. =
span>ORCID https://orcid.org/0000-0002-0676-8585
[5]=
Farmacêutico pela Universidade Federal do Cea=
rá – UFC. Doutor em Biotecnologi=
a em
Saúde pela Rede Nordeste de Biotecnologia – RENORBIO. Docente dos Cursos de=
Enfermagem
e Farmácia da Universidade da Integração
Internacional da Lusofonia Afro-Brasileira – UNILAB. Redenção - CE,
Brasil. ORCID https://orcid.org/0000-0002=
-2333-5343
[6]=
Odontóloga =
pela Universidade
Federal do Ceará – UFC.
Doutora em Ciências Médicas pela UFC. Mestre em Farmacologia pela UFC. Doce=
nte
dos Cursos de Enfermagem e Farmácia da Universi=
dade
da Integração Internacional da Lusofonia Afro-Brasileira – UNILAB.
Redenção - CE, Brasil. ORCID https://orcid.org/0000-0002-9007-7970
<=
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