title: Calculated and perceived cardiovascular risk in asymptomatic subjects submitted to a routine medical evaluation: The perception gap.
abstract: BACKGROUND
  Poor adherence to medical treatment represents a major health problem. A subject's misperception of his own cardiovascular risk has been indicated as a key driver for low compliance with preventive measures. This study analysed the relationship between objectively calculated short- and long-term cardiovascular risk and its subjective perception.
  
  
  METHODS
  Cross-sectional study in asymptomatic Brazilian subjects.
  
  
  METHODS
  Individuals (N = 6544, mean age 49.1 ± 7 years, 22.2% female) who underwent a routine mandatory health evaluation were studied. A questionnaire in which each individual rated his own cardiovascular risk as low, intermediate or high according to his own perception was used. The 10-year and lifetime cardiovascular risk were calculated respectively using the Framingham risk (FRS) and Lifetime risk (LRS) scores. Individuals were classified as hypo-perceivers (i.e. perceived risk lower than estimated risk), normo-perceivers (i.e. perceived risk coincident with estimated risk) and hyper-perceivers (i.e. perceived risk higher than estimated risk).
  
  
  RESULTS
  Cardiovascular risk, using the FRS, was low in 77.9% (N = 5071), intermediate in 14.4% (N = 939) and high in 7.7% (N = 499) of subjects. Cardiovascular risk, using the LRS, was low in 7.6% (N = 492), intermediate in 43.1% (N = 2787) and high in 49.3% (N = 3184) of the study population. The prevalence of normo-perceivers was 57.6% using the FRS and only 20.6% using the LRS. Using the LRS, 72.3% of the intermediate and 91.2% of the high-risk subjects were hypo-perceivers.
  
  
  CONCLUSIONS
  In a large sample of asymptomatic individuals, there was a gap between calculated and perceived cardiovascular risk. Using a long-term risk score, most of the intermediate- and high-risk subjects were hypo-perceivers.
authors.affiliation: Hospital Israelita Albert Einstein, Sao Paulo, Brazil mkatz@einstein.br.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Katz
authors.affiliation: Hospital Israelita Albert Einstein, Sao Paulo, Brazil Heart Institute (InCor), University of Sao Paulo Medical School Hospital, Brazil.
authors.forename: Antonio G
authors.initials: AG
authors.lastname: Laurinavicius
authors.affiliation: Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
authors.forename: Fabio G M
authors.initials: FG
authors.lastname: Franco
authors.affiliation: Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
authors.forename: Raquel D
authors.initials: RD
authors.lastname: Conceicao
authors.affiliation: Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
authors.forename: Jose A M
authors.initials: JA
authors.lastname: Carvalho
authors.affiliation: Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
authors.forename: Antonio E P
authors.initials: AE
authors.lastname: Pesaro
authors.affiliation: Hospital Israelita Albert Einstein, Sao Paulo, Brazil Heart Institute (InCor), University of Sao Paulo Medical School Hospital, Brazil.
authors.forename: Mauricio
authors.initials: M
authors.lastname: Wajngarten
authors.affiliation: Hospital Israelita Albert Einstein, Sao Paulo, Brazil Heart Institute (InCor), University of Sao Paulo Medical School Hospital, Brazil.
authors.forename: Raul D
authors.initials: RD
authors.lastname: Santos
mesh_terms: D000328:Adult; D058070:Asymptomatic Diseases; D001938:Brazil / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003661:Decision Support Techniques; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010465:Perception; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D011795:Surveys and Questionnaires
keywords: Cardiovascular disease; perception; risk