Changes in Cardiovascular Emergency Risk Perception, Preparedness, and Blood Pressure Following a Risk-Mitigation Educational Program in Postmenopausal Women: A One-Group Pretest–Posttest Study.
DOI:
https://doi.org/10.58439/jhrt.v4i2.533Keywords:
cardiovascular emergency; health education; postmenopausal women; risk perception; emergency preparedness; blood pressureAbstract
Background: Cardiovascular disease remains a major cause of mortality in women, and the menopause transition is accompanied by adverse changes in cardiometabolic and vascular risk. In addition, women may experience under-recognition of cardiovascular symptoms and delays in seeking emergency care. Theory-based education may strengthen risk perception and preparedness for appropriate responses to cardiovascular warning signs.
Objective: To evaluate changes in cardiovascular risk perception and emergency-response preparedness, as well as systolic and diastolic blood pressure, following a cardiovascular emergency risk-mitigation educational program among postmenopausal women.
Methods: A one-group pretest–posttest study was conducted among 46 postmenopausal women residing at the Tresna Werdha Indralaya Nursing Home, Indonesia. Participants were recruited using purposive sampling. The intervention comprised four sessions addressing cardiovascular risk, recognition of warning signs, decision-making, and case-based emergency-response simulation. Outcomes were assessed before and after the program using the Cardiovascular Disease Risk Perception and Response Scale (CVD-RPRS) and blood-pressure measurement. Pre–post differences were analyzed using paired-samples t-tests with a two-sided significance level of 0.05.
Results: Participants had a mean age of 72.61 ± 7.09 years (range 60–85 years). The mean CVD-RPRS score increased from 96.04 ± 2.51 to 101.02 ± 2.73 (mean change 4.98; p<0.001). Mean systolic blood pressure decreased from 157.35 ± 11.62 to 155.20 ± 11.13 mmHg (mean change −2.15 mmHg; p<0.001), while mean diastolic blood pressure decreased from 88.85 ± 6.51 to 86.80 ± 6.59 mmHg (mean change −2.04 mmHg; p<0.001).
Conclusion: The educational program was associated with improved cardiovascular risk perception and emergency preparedness and with small short-term reductions in blood pressure. Because the study lacked a control group, these changes should not be interpreted as definitive causal effects. Controlled studies with longer follow-up are needed to confirm effectiveness and clinical relevance.
Keywords: cardiovascular emergency; health education; postmenopausal women; risk perception; emergency preparedness; blood pressure
References
Badan Kebijakan Pembangunan Kesehatan. (2024). Survei Kesehatan Indonesia (SKI) 2023: Laporan tematik dan hasil utama. Kementerian Kesehatan Republik Indonesia.
Beza, L., Leslie, S. L., Alemayehu, B., & Gary, R. (2021). Acute coronary syndrome treatment delay in low to middle-income countries: A systematic review. IJC Heart & Vasculature, 35, 100823. https://doi.org/10.1016/j.ijcha.2021.100823
Chen, Y., Li, X., Jing, G., Pan, B., Ge, L., Bing, Z., Yang, K., & Han, X. (2020). Health education interventions for older adults with hypertension: A systematic review and meta-analysis. Public Health Nursing, 37(3), 461–469. https://doi.org/10.1111/phn.12698
El Khoudary, S. R., Aggarwal, B., Beckie, T. M., Hodis, H. N., Johnson, A. E., Langer, R. D., Limacher, M. C., Manson, J. E., Stefanick, M. L., & Allison, M. A. (2020). Menopause transition and cardiovascular disease risk: Implications for timing of early prevention: A scientific statement from the American Heart Association. Circulation, 142(25), e506–e532. https://doi.org/10.1161/CIR.0000000000000912
Izadpanah, P., Saadat, N., Kabiri, B., Mohammadkhah, F., Afzali Harsini, P., & Khani Jeihooni, A. (2023). The effect of base theory educational intervention on health-promoting lifestyle in women susceptible to cardiovascular diseases: Application of the Theory of Planned Behavior. Cardiology Research and Practice, 2023, 8528123. https://doi.org/10.1155/2023/8528123
Jadmiko, A. W., Ayu, S., Adyani, M., Barbara, L., & Quratul, A. (2024). Pemberdayaan kader sebagai first responder pada kasus kegawatdaruratan kardiovaskular di Pemerintah Kota Depok. Jurnal SOLMA, 13(1), 196–203. https://doi.org/10.22236/solma.v13i1.14203
Jurgens, C. Y., Lee, C. S., Aycock, D. M., Masterson Creber, R., Denfeld, Q. E., DeVon, H. A., et al. (2022). State of the science: The relevance of symptoms in cardiovascular disease and research: A scientific statement from the American Heart Association. Circulation, 146(12), e173–e184. https://doi.org/10.1161/CIR.0000000000001089
Keivanlou, N., Babaieasl, F., Jamali, J., Baghyari, S., Dalir, Z., & Davoudi, N. (2025). The effect of education using the interactive avatar application on self-care and the ability to identify and respond to the symptoms of heart attack in patients with acute coronary syndrome: A randomized clinical trial. BMC Health Services Research, 25, 572. https://doi.org/10.1186/s12913-025-12756-z
Komaç, F., & Duru, P. (2024). The effect of education based on a health belief model and motivational interviews on cardiovascular disease risk factors and healthy lifestyle behaviour changes in patients with essential hypertension: A randomized controlled trial. Patient Education and Counseling, 120, 108126. https://doi.org/10.1016/j.pec.2023.108126
Lumbantoruan, S. M., Uligraff, D. K., & Tallutondok, E. B. (2024). Measuring cardiovascular disease risk perception: Translation and validation of the Indonesian ABCD Risk Questionnaire. Nursing Research and Practice, 2024, 7526455. https://doi.org/10.1155/2024/7526455
Maas, A. H. E. M., Rosano, G., Cifkova, R., Chieffo, A., van Dijken, D., Hamoda, H., et al. (2021). Cardiovascular health after menopause transition, pregnancy disorders, and other gynaecologic conditions: A consensus document from European cardiologists, gynaecologists, and endocrinologists. European Heart Journal, 42(10), 967–984. https://doi.org/10.1093/eurheartj/ehaa1044
Mehta, L. S., Velarde, G. P., Lewey, J., Sharma, G., Bond, R. M., Navas-Acien, A., et al. (2023). Cardiovascular disease risk factors in women: The impact of race and ethnicity: A scientific statement from the American Heart Association. Circulation, 147(19), 1471–1487. https://doi.org/10.1161/CIR.0000000000001139
Rachman, I., Wahiduddin, Maria, I. L., Mappangara, I., Jafar, N., & Riskiyani, S. (2025). Knowledge, health education, and mobile health strategies on cardiovascular disease awareness in women: A narrative review. Journal of Mid-life Health, 15(4), 228–239. https://doi.org/10.4103/jmh.jmh_163_24
Sambola, A., Halvorsen, S., Adlam, D., Hassager, C., Price, S., Rosano, G., et al. (2024). Management of cardiac emergencies in women: A clinical consensus statement of the ESC associations and working group. European Heart Journal Open, 4(2), oeae011. https://doi.org/10.1093/ehjopen/oeae011
Sutantri, Lestari, N. D., Sutrisno, R. Y., & Wulandari, L. I. (2023). I don’t want to think about it!: A qualitative study of hypertensive women’s awareness and perception of heart disease. Jurnal Promkes: The Indonesian Journal of Health Promotion and Health Education, 11(2), 155–164. https://doi.org/10.20473/jpk.v11.i2.2023.155-164
Wenger, N. K., Lloyd-Jones, D. M., Elkind, M. S. V., Fonarow, G. C., Warner, J. J., Alger, H. M., et al. (2022). Call to action for cardiovascular disease in women: Epidemiology, awareness, access, and delivery of equitable health care: A presidential advisory from the American Heart Association. Circulation, 145(23), e1059–e1071. https://doi.org/10.1161/CIR.0000000000001071
World Health Organization. (2021). Cardiovascular diseases (CVDs). World Health Organization.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Murbiah
This work is licensed under a Creative Commons Attribution 4.0 International License.
