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Primary Prevention of Cardiovascular Diseases in General Practice: Mismatch between Cardiovascular Risk and Patients' Risk Perceptions

Author

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  • T. van der Weijden

    (Department of General Practice/Centre for Quality of Care Research (WOK), Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands, Trudy.vanderWeijden@hag.unimaas.nl)

  • B. van Steenkiste

    (Department of General Practice/Centre for Quality of Care Research (WOK), Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands)

  • H.E.J.H. Stoffers

    (Department of General Practice/Centre for Quality of Care Research (WOK), Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands)

  • D.R.M. Timmermans

    (Department of Social Medicine, VU University Medical Centre, Amsterdam, The Netherlands)

  • R. Grol

    (Department of General Practice/Centre for Quality of Care Research (WOK), Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands)

Abstract

Objective. Guidelines on primary prevention of cardiovascular disease (CVD) emphasize identifying high-risk patients for more intensive management, but patients' misconceptions of risk hamper implementation. Insight is needed into the type of patients that general practitioners (GPs) encounter in their cardiovascular prevention activities. How appropriate are the risk perceptions and worries of patients with whom GPs discuss CVD risks? What determines inappropriate risk perception? Method. Cross-sectional study in 34 general practices. The study included patients aged 40 to 70 years with whom CVD risk was discussed during consultation. After the consultation, the GPs completed a registration form, and patients completed a questionnaire. Correlations between patients' actual CVD risk and risk perceptions were analyzed. Results. In total, 490 patients were included. In 17% of the consultations, patients were actually at high risk. Risk was perceived inappropriately by nearly 4 in 5 high-risk patients (incorrect optimism) and by 1 in 5 low-risk patients (incorrect pessimism). Smoking, hypertension, and obesity were determinants of perceiving CVD risk as high, whereas surprisingly, diabetic patients did not report any anxiety about their CVD risk. Men were more likely to perceive their CVD risk inappropriately than women. Conclusion. In communicating CVD risk, GPs must be aware that they mostly encounter low-risk patients and that the perceived risk and worry do not necessarily correspond with the actual risk. Incorrect perceptions of CVD risk among men and patients with diabetes were striking.

Suggested Citation

  • T. van der Weijden & B. van Steenkiste & H.E.J.H. Stoffers & D.R.M. Timmermans & R. Grol, 2007. "Primary Prevention of Cardiovascular Diseases in General Practice: Mismatch between Cardiovascular Risk and Patients' Risk Perceptions," Medical Decision Making, , vol. 27(6), pages 754-761, November.
    • Handle: RePEc:sae:medema:v:27:y:2007:i:6:p:754-761
    DOI: 10.1177/0272989X07305323
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    References listed on IDEAS

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    1. Avis, N.E. & Smith, K.W. & McKinlay, J.B., 1989. "Accuracy of perceptions of heart attack risk: What influences perceptions and can they be changed?," American Journal of Public Health, American Public Health Association, vol. 79(12), pages 1608-1612.
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    Cited by:

    1. Anda Rožukalne & Vineta Kleinberga & Alise Tīfentāle & Ieva Strode, 2022. "What Is the Flag We Rally Around? Trust in Information Sources at the Outset of the COVID-19 Pandemic in Latvia," Social Sciences, MDPI, vol. 11(3), pages 1-18, March.
    2. Carlos Brotons & Irene Moral & Diana Fernández & Mireia Puig & M. Teresa Vilella & Teresa Puig & LLuís Cuixart & Gemma Férriz & Anna M. Pedro & Roger Codinachs & Mónica Rodríguez & Rubén Fuentes & on , 2021. "Effectiveness of an Intervention Aimed at Improving Information for Patients with High Cardiovascular Risk: INFORISK Clinical Trial," IJERPH, MDPI, vol. 18(7), pages 1-10, March.

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