Caregiver Knowledge and Awareness of Heart Failure Symptoms and Risk Factors Among Patients with Cardiovascular Disease: A Cross-Sectional Study from Jordan

Abstract

Background and Purpose: Cardiovascular disease (CVD) remains the leading cause of death globally and accounts for over 40% of annual deaths in Jordan. Heart failure (HF), a major sequela of advanced CVD, is increasing in prevalence and imposes high rates of morbidity, readmission, and mortality. In HF management, caregivers play a pivotal role in symptom monitoring, adherence to therapy, and early recognition of deterioration. This study aimed to assess caregivers’ knowledge regarding cardiovascular risk factors and heart failure symptoms among patients with established coronary heart disease (CHD) in Jordan, and to identify predictors of higher knowledge levels.

Methods: A cross-sectional study was conducted in the cardiology clinics at Jordan University Hospital (JUH). A total of 469 caregivers of patients with CHD completed a self-administered questionnaire assessing sociodemographic data, awareness of cardiovascular and HF risk factors, and recognition of acute cardiac and HF symptoms. Statistical analysis identified patterns and factors influencing knowledge.

Results: The mean age of participants was 44.4 ± 15.9 years, and 54.2% were male. Overall, 84.6% of caregivers correctly answered over 70% of general CVD risk-factor questions. While 95% recognized chest pain as a major cardiac warning sign, only 53.5% identified jaw pain and 74.8% arm pain as possible indicators of acute cardiac events. Awareness of hallmark HF symptoms—such as dyspnea, orthopnea, fatigue, ankle swelling, and rapid weight gain—was considerably lower. Factors associated with higher knowledge included older age, higher income, regular health checkups, and personal history of CVD, CKD,or diabetes.

Conclusions: Although general CVD knowledge among caregivers was satisfactory, notable deficits exist in recognizing HF-specific and atypical cardiac symptoms. Enhancing caregiver education especially regarding HF symptom recognition and early intervention could improve adherence, reduce hospitalizations, and enhance quality of life for HF patients in Jordan. Structured caregiver education should be integrated into cardiac discharge and follow-up care.