title: Perceptions of cardiovascular risk among patients with hypertension or diabetes.
abstract: We aimed to examine risk perceptions among patients at moderate to high cardiovascular risk. A questionnaire about perceived absolute risk of myocardial infarction and stroke was sent to 2424 patients with hypertension or diabetes. Response rate was 86.3% and 1557 patients without atherosclerotic disease were included. Actual cardiovascular risk was calculated by using Framingham risk functions. A total of 363 (23.3%) of the 1557 patients did not provide any risk estimates and these were particularly older patients, patients with a lower educational level, and patients reporting no alcohol consumption. The remaining 1194 patients tended to overestimate their risk. In 42.3% (497/1174) and 46.8% (541/1155) of the cases, patients overestimated their actual 10-year risk for myocardial infarction and stroke, respectively, by more than 20%. Older age, smoking, familial history of cardiovascular disease (CVD), and actual absolute risk predicted higher levels of perceived absolute risk. Male sex, higher scores for an internal health locus of control, lower scores for a physician locus of control, and self-rated excellent or (very) good health were positively related to higher accuracy. In conclusion, patients showed inadequate perceptions of their absolute risk of cardiovascular events and physicians should thus provide greater information about absolute risk when offering preventive therapy.
authors.affiliation: Centre for Quality of Care Research, University of Nijmegen/Maastricht, PO Box 9101, 6500 HB, Nijmegen, The Netherlands. frijling@knmg.nl
authors.forename: Bernard D
authors.initials: BD
authors.lastname: Frijling
authors.forename: Claudia M
authors.initials: CM
authors.lastname: Lobo
authors.forename: Inge M
authors.initials: IM
authors.lastname: Keus
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Jenks
authors.forename: Reinier P
authors.initials: RP
authors.lastname: Akkermans
authors.forename: Marlies E J L
authors.initials: ME
authors.lastname: Hulscher
authors.forename: Ad
authors.initials: A
authors.lastname: Prins
authors.forename: Johannes C
authors.initials: JC
authors.lastname: van der Wouden
authors.forename: Richard P T M
authors.initials: RP
authors.lastname: Grol
mesh_terms: D000367:Age Factors; D001294:Attitude to Health; D048909:Diabetes Complications; D004522:Educational Status; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000150:complications*; D007389:Internal-External Control; D008019:Life Style; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology* / Q000517:prevention & control; D009426:Netherlands; D009765:Obesity / Q000150:complications; D010353:Patient Education as Topic; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D020521:Stroke / Q000209:etiology* / Q000517:prevention & control; D011795:Surveys and Questionnaires