Reducing cardiovascular risk in women with lupus: perception of risk and predictors of risk-reducing behaviors.
BACKGROUND
Women with systemic lupus erythematosus (SLE) display a 7- to 10-fold increased risk for cardiovascular disease (CVD) compared with non-SLE controls, yet many are unaware of this risk despite years spent in the healthcare system. It is not clear why they lack awareness of increased CVD risk or which factors influence awareness.


OBJECTIVE
The purpose of this study was to assess in women with SLE their perceived CVD risk, the association between clinically identified and perceived CVD risk factors, and factors that influenced CVD risk awareness and adoption of risk-reducing behaviors.


METHODS
Questionnaires, face-to-face meetings, and clinical assessments were used to collect data on demographics, perceived CVD risk, perceived CVD risk factors, actual CVD risk factors, risk-reducing behaviors, and healthcare provider counseling from 60 women with SLE. Regression analyses identified factors that influenced risk awareness and adoption of risk-reducing behaviors.


RESULTS
Two-thirds of the participants perceived themselves at increased CVD risk when compared with women without SLE, but the same number did not perceive an increase in their absolute CVD risk. Age was a significant predictor (P = .05) for awareness of increased absolute risk; younger age correlated with increased awareness. Most women received information about heart disease from public media. On average, participants had 4 CVD risk factors but perceived that they had only 2. Age (P = .001) and the number of perceived risk factors (P = .004) predicted adoption of risk-reducing behaviors (P = .03).


CONCLUSIONS
Participants underestimated their CVD risk factors and did not personalize their increased CVD risk. Healthcare providers' identification and discussion of CVD risk factors in women with SLE may enhance their CVD risk awareness and the adoption of risk-reducing behaviors.
Patricia K. Weinstein, PhD, ARNP, NP-C, CNE Adjunct Faculty, College of Nursing, University of Central Florida, Orlando. Ali Amirkhosravi, PhD Principal Scientist, Florida Hospital Center for Thrombosis Research, Orlando. Theodore J. Angelopoulos, PhD, MPH Professor, College of Health and Public Affairs, University of Central Florida, Orlando. Angeline Bushy, PhD, RN, FAAN, PHCNS-BC Bert Fish Eminent Scholar Endowed Chair, Professor, and Coordinator, College of Nursing, University of Central Florida, Daytona. Maureen M. Covelli, PhD, RN Associate Professor, College of Nursing, University of Central Florida, Orlando. Karen E. Dennis, PhD, RN, FAAN Professor, College of Nursing, University of Central Florida, Orlando.
Patricia K
PK
Weinstein
Ali
A
Amirkhosravi
Theodore J
TJ
Angelopoulos
Angeline
A
Bushy
Maureen M
MM
Covelli
Karen E
KE
Dennis
D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000517:prevention & control*; D003142:Communication; D015897:Comorbidity; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology*; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior