title: Comparison of self-perceived cardiovascular disease risk among smokers with Framingham and PROCAM scores: a cross-sectional analysis of baseline data from a randomised controlled trial.
abstract: Previous studies suggest that smokers have a misperception of their 10-year cardiovascular risk. We aimed to compare 10-year cardiovascular risk self-perception and calculated risk among smokers willing to quit and assess the determinants of a possible misperception.
  
  
  
  Cross-sectional secondary analysis of baseline data from a randomised controlled trial of smoking cessation.
  
  
  
  514 participants, mean age 51.1 years, 46% women, 98% Caucasian. Eligible participants were regular smokers, aged between 40 and 70 years, with a consumption of at least 10 cigarettes per day for at least a year. None of them had experienced cardiovascular disease before. Exclusion criteria comprised a history of myocardial infarction, coronary heart disease, stroke, heart failure, peripheral vascular disease, carotid atherosclerosis or cardiac arrhythmia. Participants with renal or liver failure, psychiatric disorders, substance and alcohol abuse and with smoking cessation therapies were excluded.
  
  
  
  Participants were asked to estimate their 10-year cardiovascular risk using a 3-item scale corresponding to high-risk, moderate-risk and low-risk categories. We compared their risk perception with Framingham and Prospective Cardiovascular Munster Study (PROCAM) scores. We used multivariable-adjusted logistic regression models to determine characteristics of participants who underestimate their risk versus those who correctly estimate or overestimate it.
  
  
  
  Between 38% and 42% of smokers correctly perceived their 10-year cardiovascular risk, and 39-50% overestimated their 10-year cardiovascular risk while 12-19% underestimated it compared with their calculated 10-year cardiovascular risk depending on the score used. Underestimation of 10-year cardiovascular risk was associated with male gender (OR 8.16; CI 3.83 to 17.36), older age (OR 1.06; CI 1.02 to 1.09), and the presence of hyperlipidaemia (OR 2.71; CI 1.47 to 5.01) and diabetes mellitus (OR 13.93; CI 3.83 to 50.66).
  
  
  
  Among smokers, misperception of their 10-year cardiovascular risk is common, with one-fifth underestimating it. These findings may help physicians target patients with such characteristics to help them change their health behaviour and adherence to risk-reduction therapy.
  
  
  
  NCT00548665; Post-results.
authors.affiliation: Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland.|Service of Cardiology, University Hospital of Lausanne, Lausanne, Switzerland.
authors.forename: Benoît
authors.initials: B
authors.lastname: Desgraz
authors.affiliation: Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland.|Service of Endocrinology, Diabetes and Metabolism, University Hospital of Lausanne, Lausanne, Switzerland.
authors.forename: Tinh-Hai
authors.initials: TH
authors.lastname: Collet
authors.affiliation: Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.|Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Rodondi
authors.affiliation: Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland.
authors.forename: Jacques
authors.initials: J
authors.lastname: Cornuz
authors.affiliation: Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland.
authors.forename: Carole
authors.initials: C
authors.lastname: Clair
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D002318:Cardiovascular Diseases / Q000209:etiology*; D000073865:Cigarette Smoking / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012649:Self Concept; D000074285:Smokers / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology; D062789:Tobacco Products / Q000706:statistics & numerical data
keywords: EPIDEMIOLOGY; PREVENTIVE MEDICINE; PRIMARY CARE