Abstract

Assessing the ‘accuracy’ of cardiovascular risk perception is a worthy scientific goal that may lead to targeted interventions aimed at improving risk communication and health outcomes. Current cardiovascular risk scores, however, have shown poor calibration when used in populations that differ temporally and/or geographically from the derivation sample, limiting their reliability as the reference standard for absolute risk. In addition, accurately assessing risk awareness is challenging, with few available validated tools for effectively accounting for the outcomes assessed (coronary heart disease vs. cardiovascular disease), the time span of prediction (10-year vs. lifetime risk), and concepts of absolute versus relative risk. In this context, assessing patient awareness of the role of age as the key, non-modifiable driver of absolute risk can be particularly challenging. This commentary will examine each of these issues, providing context for the interpretation of studies on ‘discordance’ between calculated and perceived cardiovascular risk, such as the one recently published by Oertelt-Prigione et al. Moreover, we explore alternative approaches aimed at overcoming those limitations, enhancing understanding of the factors and true magnitude associated with such discordance.Please see related article: http://www.biomedcentral.com/1741-7015/13/52.

Highlights

  • Accurate patient perception of risk is critical for influencing behavioral change and adherence to pharmacologic treatments in the prevention of cardiovascular disease (CVD)

  • The phenomenon of CVD risk misperception may be notable among women

  • Recent studies have found that women from high-income countries, for whom CVD is the number one cause of death, have strikingly low levels of awareness regarding the role of hypertension

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Summary

Introduction

Accurate patient perception of risk is critical for influencing behavioral change and adherence to pharmacologic treatments in the prevention of cardiovascular disease (CVD). Recent studies have found that women from high-income countries, for whom CVD is the number one cause of death, have strikingly low levels of awareness regarding the role of hypertension, Assessing risk awareness in the BEFRI Study BMC Medicine has recently published a research article by Oertelt-Prigione et al [4] showing, in a sample of 1,062 urban women from the Berlin Female Risk Evaluation (BEFRI) Study, the prevalence and independent predictors of discordance between perceived and calculated 10-year risk using the 2008 CVD Framingham Risk Score (FRS).

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