Heart Health: Views and experiences of Hertfordshire residents

The Hertfordshire and West Essex Integrated Care Board (ICB) Primary Care Board asked Healthwatch Hertfordshire to investigate public understanding of cardiovascular disease and people’s experiences of diagnoses.

Nearly 230 Hertfordshire residents responded to a survey between March and May 2023.

Of those who responded, 107 (47%) had a medical diagnosis of high blood pressure, Atrial Fibrillation and/or high cholesterol. The remaining 122 (53%) did not have any of these diagnoses.

Symptoms

• 25% of those with a diagnosis had recognised their own symptoms – with 60% visiting their GP and 20% contacting emergency services due to the severity of their symptoms.
• People aged 18-44 were most likely to recognise their own symptoms at 80%, followed by those from an Asian background at 40%. Women were also slightly more likely than men to identify their symptoms, as were those under 65 years old compared to people over 65.
• Respondents without any existing diagnosis most commonly identified breathlessness (46%) and chest pain (27%) as symptoms of heart disease as well as fatigue, dizziness and swelling.
• Worryingly, 11% of respondents said they didn’t know about symptoms and a further 35% skipped the question - which could indicate they were either unsure or not aware of the symptoms.

Diagnosis

• People from a Black ethnic background and those aged 18-44 (particularly men) were far less likely to interact with a local GP or healthcare professional about their heart health because they felt they weren’t listened to about their symptoms.
• As a result, men (particularly those under 65 years old) were more likely to be diagnosed by a hospital doctor than a GP. By not visiting a local healthcare professional earlier, they often experienced more severe symptoms and ended up in emergency care.
• Even amongst people aged over 75, only 57% recalled speaking about their heart health with a healthcare professional, although they’re at greater risk of developing heart disease.
• Concerningly, only 50% of 65 to 74-year-olds said they would visit their GP if they were worried about heart health, despite being at high risk.

Risk Factors

• The average awareness of age as a risk factor was 69% - yet only 62% of over 65-year-olds were aware of age as a risk factor and only 67% of over 75-year-olds were aware.
• Only 54% of respondents were aware that ethnic background was a risk factor.
• Respondents from Black and Asian ethnic backgrounds had a much higher awareness of risk factors associated with heart disease, yet were less likely to know their own blood pressure or cholesterol readings and were more likely to face barriers in getting a diagnosis:
  • 100% recognised high blood pressure, high cholesterol, Atrial Fibrillation, smoking, Type 2 Diabetes, inactivity, being overweight, family history, diet and alcohol consumption.
  • 80% of Black respondents recognised age (average was 69%) and 60% of Black respondents recognised gender (average was 49%).
  • 100% of Black respondents and 71% of Asian respondents recognised ethnic background.

Self-Management/Healthy Lifestyles

• The majority (61%) of respondents said they tried to look after their heart health by living a healthy lifestyle, including eating healthily, regularly exercising, not smoking and limiting their alcohol intake.
• There was a significant gender divide, with 83% of women considering their heart health in their everyday choices either “a lot” or “a little”, compared to 56% of men - despite men’s increased risk.
• People with less disposable income said they found it more difficult to maintain a healthy lifestyle, with Cost of Living pressures adding to the difficulties.