Abstract P060: Factors Affecting Cardiovascular Risk Perception in Subjects Submitted to a Routine Health Evaluation
Introduction: Cardiovascular (CV) disease remains the main cause of death worldwide and preventive measures may decrease CV adverse events. Individuals’ subjective perception of own CV risk has been pointed as a key driver for patients’ engagement on medical recommendations. However, recent studies indicate that subjects usually are hypo-perceivers and may underestimate their own CV risk. Fewer studies have evaluated the factors associated with CV risk hypo-perception. Therefore, the aim of this study was to test the association between clinical characteristics and individual’s perception of CV risk.
Hypothesis: traditional CV risk factors would be associated with subjects’ perception of CV risk.
Methods: Patients (n = 5,863, 47.9 ± 6.2 years, 22.1% female) who underwent a routine health evaluation, and for whom the lifetime risk score (LRS) indicated an intermediate or high CV risk were included in this analysis. All individuals subjectively rated their CV risk for the next years as low, intermediate or high, and this perception was compared to the LRS. Individuals were then classified as hypo-perceivers, i.e. perceived risk lower than estimated risk and normo-perceivers, i.e. perceived risk coincident with the estimated risk. Logistic regression analysis was performed to test the association between clinical characteristics (including CV risk factors) and individuals’ perception of risk. P<0.05 was considered statistically significant.
Results: Cardiovascular risk was intermediate in 45.7% and high in 54.3% of individuals as provided by de LRS. When comparing the LRS with subjects’ perception of risk, 4,918 (83.9%) were hypo-perceivers and 945 (16.1%) were normo-perceivers. By adjusted logistic regression analysis, age (OR=1.02 [95%CI 1.01-1.04]; p=0.006), smoking (OR 2.04 [95%CI 1.43-2.91]; p<0.001), dyslipidemia (OR 1.21 [95%CI 1.01-1.46]; p=0.043), physical activity (OR 1.67 [95%CI 1.37-2.03]; p<0.001) and use of medications (OR 3.50 [95%CI 2.55-4.81]; p<0.001) increased the chance of risk hypo-perception, while a higher BMI (OR 0.36 [95%CI 0.28-0.47]; p<0.001), hypertension (OR 0.57 [95%CI 0.41-0.80]; p=0.001), depression (OR 0.46 [95%CI 0.37-0.57]; p<0.001) and stress (OR 0.40 [95%CI 0.33-0.49]; p<0.001) decreased the chance of risk hypo-perception. Diabetes and gender were not associated with individuals’ perception of risk.
Conclusions: Among asymptomatic individuals submitted to a routine medical evaluation there was a high prevalence of hypo-perception of CV risk. Aging, smoking, dyslipidemia, physical activity and the use of medications were associated with a higher chance of risk hypo-perception. Thus, subjects in these conditions may benefit from a more careful risk orientation on health check-ups.
Author Disclosures: T.N. Helou: None. R.D. Santos: D. Speakers Bureau; Modest; Astra Zeneca, Biolab, Boehringer-Ingelheim, Amgen, Sanofi, Novartis, Eli Lilly, Bristol Myers Squibb, Pfizer, Genzyme. A.G. Laurinavicius: None. F.G.M. Franco: None. R.D.O. Conceicao: None. J.A.M. Carvalho: None. A.E.P. Pesaro: None. F.M.F. Silva: None. M. Wajngarten: None. M. Katz: None.
- © 2015 by American Heart Association, Inc.