People with a higher level of education have a reduced risk of developing heart failure after a heart attack, a new study has found.

Heart failure is a potentially life-threatening condition which leads to the heart being unable to pump enough blood around the body. Symptoms include tiredness, shortness of breath, dizziness and swollen ankles and around 90,000 people are currently living with the condition in Ireland.

According to Norwegian researchers, heart failure ‘is a serious complication of acute myocardial infarction (heart attack) and substantially increases the risk of death'.

Previous research has suggested that people are more likely to die following a heart attack if they have lower levels of education, however the reasons for this were unclear.

"Heart failure is the most important incident in the chain of events leading to death after a heart attack and we hypothesised that it might contribute to the observed educational disparities in survival," the researchers said.

They looked at the potential link between education and the risk of developing heart failure after a heart attack in over 70,500 people aged between 35 and 85.

All of the participants had been hospitalised for a first heart attack between 2001 and 2009 and had no history of heart failure.

Their levels of education were grouped as primary (up to 10 years of compulsory education), secondary (equivalent of secondary school) and tertiary education (college/university).

For the purpose of the study, heart failure was classified into two groups - early-onset (the patient had heart failure on admission for their heart attack or developed it in hospital) and late-onset (hospitalised another time with heart failure or died as a result of heart failure after being discharged from hospital for their original heart attack).

Of the more than 70,500 participants, almost 18% were diagnosed with early-onset heart failure. The study found that those with a secondary education had a 9% reduced risk of developing heart failure after a heart attack and those with a tertiary education had a 20% reduced risk compared to those with only primary education.

Almost 12% of the participants were also found to have late-onset heart failure during an average follow-up time of three years. Those with a secondary education had a 14% reduced risk of developing heart failure, while those with a tertiary education had a 27% reduced risk.

The results were similar in men and women.

"Education per se cannot be considered a ‘protective exposure' in the classical sense but represents a clustering of characteristics that influence health behaviours and outcomes. It has been shown that patients with lower education tend to delay seeking medical care when heart attack symptoms occur and they have poorer access to specialised care.

"Both of these factors increase the risk of developing early-onset heart failure after heart attack. Those with lower education are more likely to have co-existing medical conditions and unhealthy lifestyles which also increase the risk of heart failure," explained the study's lead author, Dr Gerhard Sulo, of the University of Bergen.

He said that ‘focused efforts' are needed to ensure that people who have suffered a heart attack and have low education levels ‘get help early, have equal access to treatment, take their medications and are encouraged to improve their lifestyles'.

"This should help reduce the socioeconomic gap in the risk of heart failure following a heart attack."

Details of these findings are published in the European Journal of Preventive Cardiology.