Cardiovascular Disease Risk Perception Research Articles

한국 생산직 근로자들의 심혈관질환 관련 지식, 인식, 신념 및 예방행위: 내용분석을 통한 심혈관질환 위험 감소 중재 프로그램 개발을 위한 요구사정

Purpose: This study intended to grasp real context of Cardiovascular disease (CVD)-related factors of Korean blue-collar workers, especially CVD-related knowledge, perception, beliefs, benefits and barriers of behaviors according to the health belief model. Methods: We interviewed twenty two workers working in two small-sized companies and performed two series of focus group interviews. Data were analyzed by deductive content analysis approach based on Elo & Kyngas. Results: Excepting participants who have CVD risk factors, most participants had lower level of CVD risk perception. The level of CVD knowledge was low but there was difference by gender. CVD-related beliefs were 'fatal disease', 'caused by lifestyle' and 'difficult to prevent by themselves'. The risk reduction behaviors were motivated by current or family history of hypertension. But there were barriers to interfere practice of preventive behaviors such as poor quality of food provided by cafeteria in the workplace, frequent overtime, victim mentality as one of vulnerable social group, housework and financial burden, lack of facilities for rest and physical activity in the workplace. Conclusion: To develop intervention for reducing CVD risks in Korean blue-collar workers, we need to focus on improving CVD knowledge and perception and modifying work-related environments such as low quality of food and lack of facilities for rest and physical activity in the workplace.

A study of the psychological predictors controlling the risk factors of cardiovascular diseases

Background: It seems that more cardinal steps can be taken towards constraining cardiovascular diseases (CVD) through the identification of relevant factors and predictors of behaviors associated with cardiac health. Objectives: The present study is aimed to investigate the health literacy of cardiovascular diseases (CVD), personality traits, perception of cardiovascular disease risk and their relationships with controlling behaviors associated with cardiac health through playing self-efficient intervention roles. Methods: The statistical population of the present study consisted of residents of Kermanshah, Iran in 2015. Additionally, due to the possibility of sample attrition and uncooperative subjects during the study, a total sample of 800 subjects was selected using cluster sampling. After data collection, they were analyzed using structural equation modeling (SEM). Results: The results demonstrated that there were significant correlations between personality traits and controlling the risk factors of cardiovascular diseases. Similarly, significant correlations were found between controlling the risk factors of cardiovascular diseases and self-efficacy, health literacy of cardiovascular diseases (CVD) and perception of cardiovascular diseases. Further, the results showed that controlling behaviors associated with cardiac health had the greatest direct effects on the path of perception of cardiovascular diseases. Conclusions: It can be concluded that neuroticism, impulsive sensation seeking and hostility result in risky behaviors of cardiovascular diseases (CVD) when self-efficacy is low and the cardiovascular disease (CVD) risk factors are controlled through health literacy and perception of cardiovascular diseases when self-efficacy is high.

Perceived and actual risk of cardiovascular disease in patients with rheumatoid arthritis in Korea: A cross-sectional study.

The purposes of this study were to compare the perceived and actual 10-year risk for cardiovascular disease (CVD) and to evaluate the influence of cardiovascular risk factors on perceived CVD risk in patients with rheumatoid arthritis (RA) in Korea. Additionally, the attainment of CVD prevention guideline goals by 3 levels of CVD risk (low, moderate, and high) was presented.For this cross-sectional study, data were collected from 208 patients with RA. Actual CVD risk was estimated with the Systematic Coronary Risk Evaluation (SCORE), and goal attainment was assessed based on the European League Against Rheumatism guidelines. Actual CVD risk and perceived risk were compared with cross-tabulation. Chi-square tests were used to evaluate differences in cardiovascular risk factors by perceived risk. Levels of goal attainment were presented in percentages.Among patients with RA, 13.9% were identified as being at high risk for CVD, whereas 39.9% were at moderate risk, and 46.2% were at low risk. The majority of those at high risk (96.6%) underestimated their risk for CVD. The use of antihypertensive or lipid-lowering medications and having a parental history of CVD significantly increased the likelihood that subjects with RA would perceive themselves as being at high risk for CVD. Diabetes, smoking, physical inactivity, and obesity did not affect perceived risk. A substantial proportion of the subjects with RA did not meet the prevention guideline goals.Patients with RA who are at increased risk of developing CVD must be managed as soon as possible to attain the guideline goals and, accordingly, lower their risk of future CVD.

The Role of Family in a Dietary Risk Reduction Intervention for Cardiovascular Disease.

Diet is an essential strategy for the prevention of primary and secondary cardiovascular disease (CVD) events. The objectives were to examine: how families at increased risk of CVD perceived personal risk, their motivations to make dietary changes, their understanding of diet, and the influence of other family members. Individuals (>18 years) who completed an Australian family-based CVD risk reduction program were invited to a semi-structured telephone interview. Responses were recorded, transcribed verbatim and analysed using a systematic deductive approach with coding derived from key concepts developed as part of the interview structure. Seventeen participants from eight families were interviewed (aged 18–70 years, 47% male, five with CVD diagnosis). Key themes indicated both intrinsic and extrinsic motivations to improve heart health, variations in risk perception, recognition of the role diet plays in heart health, and the extent of family influences on eating patterns. Discrepancies between perceived and actual CVD risk perception impacted on perceived “need” to modify current dietary patterns towards heart health recommendations. Therefore, strategies not reliant on risk perception are needed to engage those with low risk perception. This could involve identifying and accessing the family “ringleader” to influence involvement and capitalising on personal accountability to other family members.

Outcomes of a Pilot Intervention Study for Young Adults at Risk for Cardiovascular Disease Based on Their Family History.

Lifestyle choices have a significant impact on cardiovascular disease (CVD) risk. Interventions to promote a heart-healthy lifestyle in young adults at long-term high risk for CVD are needed to decrease the burden of CVD. However, few interventions with this purpose have been developed. The objective of this study was to examine the effect of a pilot intervention on young adults with a family history of CVD that used 3-generation pedigrees, risk factor information, and counseling on heart disease knowledge, perceived CVD risk, and intention to engage in a heart-healthy lifestyle. A pretest-posttest design, with within-group analysis, was used to examine the effect of the intervention. Paired t test and Wilcoxon signed rank tests were used to examine the changes in heart disease knowledge, perceived risk, and behavioral intention from baseline to postintervention. The Cohen d was calculated to examine the effect of the intervention on study measures. In addition, Spearman ρ was used to examine the associations between postintervention perceived risk, postintervention behavioral intention, and family history. The sample for the pilot study included 15 mostly white and mostly female healthy young adults between the ages of 18 and 25 years. The intervention was effective at increasing CVD knowledge (P = .02) and had a medium effect on perceived risk and intention to engage in a heart-healthy lifestyle (Cohen d, 0.48-0.58). There were significant associations between postintervention perceived risk and postintervention intention to exercise and the participants' family history of coronary heart disease (r = 0.62, P = .014 and r = 0.55, P = .035, respectively). Interventions are needed to increase individuals' awareness of their long-term CVD risk and to improve their ability to make lifestyle changes. Although this intervention was only tested in a small sample, it shows promise to improve heart disease knowledge and perceived lifetime CVD risk and may effect longer-term risk for CVD.

Perceptions Related to Cardiovascular Disease Risk in Caucasian College Males.

Among younger adults, risk for cardiovascular disease (CVD) is higher among men than women. Young adult males in college engage in multiple behaviors that are associated with CVD risk. Although researchers have previously explored perceptions of factors related to hypertension in African American college males, surprisingly little is known about perceptions of CVD risk in Caucasian college males. A better understanding of these perceptions may be helpful in creating interventions to improve cardiovascular health in college men. Therefore, the purpose of this study was to explore Caucasian male college students' perceptions of CVD risk. A qualitative descriptive study using semistructured, individual interviews was conducted using a sample of 10 undergraduate Caucasian males in college (mean age 20 years) free of CVD and not enrolled in a health-related major. Interviews were audio recorded, transcribed verbatim, and analyzed for themes using content analysis. The data reflected two primary themes regarding perceptions related to cardiovascular risk: barriers to implementing healthy lifestyle choices and impact of behaviors on CVD risk. Barriers to implementing healthy lifestyles included availability of unhealthy foods, time constraints, convenience, social influences, and ignoring long-term consequences of behaviors. Students primarily emphasized the importance of diet and physical activity in reducing CVD risk. Future research should focus on interventions to overcome college-specific barriers to engaging in healthy behaviors among men.

Impact of provision of cardiovascular disease risk estimates to healthcare professionals and patients: a systematic review

ObjectiveTo systematically review whether the provision of information on cardiovascular disease (CVD) risk to healthcare professionals and patients impacts their decision-making, behaviour and ultimately patient health.DesignA systematic review.Data sourcesAn electronic...

Design and rationale for the Patient and Provider Assessment of Lipid Management (PALM) registry

Despite improvements in diagnosis and treatment, the prevalence of hyperlipidemia among adults in the United States remains high. Data are limited on treatment patterns and patient perceptions of cardiovascular disease risk since the release of new lipid guidelines. The objectives of the PALM registry are to assess contemporary patterns of lipid-lowering therapy use among adults receiving care in a nationally representative cohort of community clinics, determine consistency of treatment with varying lipid guidelines, identify factors affecting use of lipid-lowering therapy including patient-reported statin intolerance, and assess patient and provider knowledge of cardiovascular risk reduction goals. The PALM registry will enroll 7,500 patients likely to be considered for lipid-lowering therapy from 175 cardiology, primary care, and endocrinology practices across the United States. In this cross-sectional, observational registry, a novel tablet-based platform will be used to collect patient-reported knowledge, attitudes, and beliefs regarding cardiovascular risk reduction and lipid management. Chart abstraction and core laboratory lipid levels will describe current lipid management. Provider surveys will assess perception of current lipid-lowering goals and barriers to optimal cardiovascular risk reduction. The PALM registry will allow for better understanding of current practice patterns, patient experiences, and patient and provider attitudes toward cholesterol management for cardiovascular disease risk reduction. These data can be used to better understand gaps in care and design targeted interventions to improve uptake of lipid-lowering therapies for cardiovascular risk reduction.

371: Perception of risk of cardiovascular disease in obese and gestational diabetic patients

To evaluate self-perceived risk of cardiovascular disease (CVD) in postpartum patients with gestational diabetes (GDM) or obesity. Given the focused health education provided to GDM patients, we hypothesized that GDM patients would have a heightened perception of CVD risk compared to non-diabetic controls, whereas obese patients would not differ in their CVD risk perception compared to non-obese non-diabetic controls.

Reducing Cardiovascular Risk in Women With Lupus

Women with systemic lupus erythematosus (SLE) display a 7- to 10-fold increased risk for cardiovascular disease (CVD) compared with non-SLE controls, yet many are unaware of this risk despite years spent in the healthcare system. It is not clear why they lack awareness of increased CVD risk or which factors influence awareness. The purpose of this study was to assess in women with SLE their perceived CVD risk, the association between clinically identified and perceived CVD risk factors, and factors that influenced CVD risk awareness and adoption of risk-reducing behaviors. Questionnaires, face-to-face meetings, and clinical assessments were used to collect data on demographics, perceived CVD risk, perceived CVD risk factors, actual CVD risk factors, risk-reducing behaviors, and healthcare provider counseling from 60 women with SLE. Regression analyses identified factors that influenced risk awareness and adoption of risk-reducing behaviors. Two-thirds of the participants perceived themselves at increased CVD risk when compared with women without SLE, but the same number did not perceive an increase in their absolute CVD risk. Age was a significant predictor (P = .05) for awareness of increased absolute risk; younger age correlated with increased awareness. Most women received information about heart disease from public media. On average, participants had 4 CVD risk factors but perceived that they had only 2. Age (P = .001) and the number of perceived risk factors (P = .004) predicted adoption of risk-reducing behaviors (P = .03). Participants underestimated their CVD risk factors and did not personalize their increased CVD risk. Healthcare providers' identification and discussion of CVD risk factors in women with SLE may enhance their CVD risk awareness and the adoption of risk-reducing behaviors.

Family History of Cardiovascular Disease, Perceived Cardiovascular Disease Risk, and Health-Related Behavior

More than 82 million Americans have 1 or more forms of cardiovascular disease (CVD), accounting for 32.8% of all deaths in the United States. Although the evidence for the familial aggregation of CVD is strong, the relationship between family history (FH) of CVD, perceived risk for CVD, and health-related behavior is poorly understood. The objective of this article was to review and summarize the published research on the relationship between an FH of CVD, an individual's perceived risk, and health-related behavior to make recommendations for clinical practice and future research. A literature search was conducted using PubMed, CINAHL Plus, and PsycINFO to identify articles that examined the relationship between an FH of CVD, perceived CVD risk, and health-promoting behaviors. A total of 263 unique articles were reviewed. A total of 238 were excluded, resulting in a total of 25 articles included in the review. There was a positive relationship between a reported FH of CVD and perceived risk. However, the relationship between an FH of CVD and health-related behavior change and perceived risk and behavior change was inconsistent. A person's awareness of his or her FH of CVD or his or her own risk for CVD is not a sufficient predictor of changes in his or her health-related behavior. Future studies are needed to better explain the processes by which perceived CVD risk or FH of CVD can be used to affect health-related behavior changes. It appears that both FH and perceived personal risk for CVD are necessary but not sufficient conditions to change health-related behavior in high-risk populations. Future studies should also test interventions that help individuals with an FH of CVD attribute increased personal risk to themselves for developing CVD, while providing lifestyle management options to minimize their risk.

Effect of an Educational Intervention on Cardiovascular Disease Risk Perception among Women with Preeclampsia

To promote knowledge and awareness about cardiovascular disease (CVD) among women with recent preeclampsia so that this population may develop more accurate perceptions of their personal CVD risk. An exploratory single group, pretest/posttest educational intervention study. Telephone-based interviews. Sixty-four women with preeclampsia in the most recent pregnancy completed the study. The sample was predominately African American. Knowledge about CVD and the study covariates (age, race, parity, income, marital status, education, and history of previous preeclampsia) were measured prior to CVD education. Levels of CVD risk perception were measured both before and after the CVD educational intervention. Structured CVD education by telephone. After CVD education, levels of CVD risk perception were significantly higher than at baseline. As an intervention, CVD education provided by telephone served as a practical and effective approach to contact postpartum women with recent preeclampsia and demonstrated effectiveness in increasing perception of CVD risk.

Cardiovascular Disease Risk Perception in a Developing World Country - Based on Location of Residence and Gender

The World Health Organization has declared cardiovascular disease (CVD) as the number one cause of mortality worldwide and the highest death rate from CVD is in the developing world. There is great interest in studying CVD in the developing world in order to try and make an impact on outcomes. Lack of knowledge of CVD risk factors and no check-ups of these risk factors makes it difficult to prevent or treat CVD. We sought to determine if patients presenting to community clinics in Ethiopia understood the harms of the CVD risk factors of smoking, diabetes and hypertension and whether they had any check-ups of blood sugar and blood pressure.

Cardiovascular Risk-Factor Knowledge and Risk Perception Among HIV-Infected Adults

Cardiovascular disease (CVD) has emerged as a major cause of morbidity and mortality in HIV-infected adults. Research in noninfected populations has suggested that knowledge of CVD risk factors significantly influences perceptions of risk. This cross-sectional study describes CVD risk factor knowledge and risk perception in HIV-infected adults. We recruited 130 HIV-infected adults (mean age=48years, 62% male, 56% current smokers, mean years since HIV diagnosis, 14.7). The mean CVD risk factor knowledge score was fairly high. However, controlling for age, CVD risk factor knowledge was not predictive of perceived risk [F(1, 117)=0.13, p>.05]. Estimated risk and perceived risk were weakly but significantly correlated; r(126)=.24, p=.01. HIV-infected adults are at increased risk for CVD. Despite having adequate risk-factor knowledge, CVD risk perception was inaccurate. Improving risk perception and developing CVD risk reduction interventions for this population are imperative.

CA1-02: Women's Perception of Cardiovascular Disease Risk Varies by Hypercholesterolemia History: Making Effective Nutritional Choices

A total of 1,220 advanced Colon cancer cases, 422 with Stage III disease prior to progression and 798 with Stage IV disease were enrolled. The proportion of patients who received chemotherapy varied by stage (87%; 256 of 294 with stage III disease and 68%; 630 of 926 with stage IV disease at time of treatment, adjusted p-value=0.0452), geographic site (range 51-83%; adjusted p-value 0.0003; age (rate decreased with increasing age, adjusted p-value < 0.0001), Charlson Score (range score 0, 76%; 147 of 196 to score 6+, 46%; 118 of 257; adjusted p-value < 0.0001), Medicare coverage (yes, 90%; 311 of 346 vs. no, 66%; 577 of 874; adjusted p-value < 0.0001), and positive family history of cancer (family history 82%; 460 of 561 vs. no family history 71%; 258 of 363; adjusted p-value <0.0456), but did not vary by BMI, patient gender, race, level of education, or household income. The median time to treatment varied by geographic site, stage, increasing age, race, Medicare coverage, college education, household income, and other therapy but did not vary by gender, BMI, Charlson Score, or positive family history.

Hold the Salt! Effects of Sodium Information Provision, Sodium Content, and Hypertension on Perceived Cardiovascular Disease Risk and Purchase Intentions

Excessive sodium intake is a major cause of hypertension, a significant risk factor for several forms of cardiovascular disease, including coronary heart disease, stroke, and heart failure. Despite this finding, the average intake among Americans is 150% of the maximum recommended level. The goal of this research is to obtain greater consumer insight into this important public health issue. The authors analyze data from the National Health and Nutrition Examination Survey 2005–2006 and conduct two experiments using a nationwide panel of consumers. The results indicate that hypertension status has a significant effect on consumers’ attention to sodium on the Nutrition Facts panel (Study 1) and moderates the influence of sodium disclosure on perceived cardiovascular disease risk and purchase intentions for restaurant items (Study 2). In addition, the authors find that sodium level on a Nutrition Facts panel interacts with the provision of health-related sodium educational materials to influence disease risk perceptions and purchase intentions (Study 3). They offer potential implications of their findings for public policy makers, the public health community, and consumers.

Factors Associated with Blue-collar Workers' Risk Perception of Cardiovascular Disease

The purpose of this study was to investigate the contribution of actual cardiovascular disease (CVD) risk, as well as, individual, psychosocial, and work-related factors as predictors of CVD risk perception among Korean blue-collar workers. The participants were 238 Korean blue-collar workers who worked in small companies. Data were collected through a survey; anthropometric and blood pressure measures; and blood sampling for lipid levels. Blue-collar workers had high actual CVD risk and low CVD risk perception. The significant predictors of risk perception included perceived health status, alcohol consumption, knowledge of CVD risk, actual CVD risk, decision latitude, and shift work. The model explained 26% of the variance in CVD risk perception. The result suggests when occupational health nurses are giving routine health examination in small companies, they can enhance CVD risk perception in blue-collar workers by providing essential information about CVD risk factors and personal counseling on the individual worker's CVD risk status.

Abstract P251: Cardiovascular Risk Perception in African Americans

Substantial racial disparities exist in heart disease. African Americans have the highest rates of cardiovascular disease (CVD). The prevalence of cardiovascular risk factors is greatest among racial minorities. African Americans are more likely to be diabetic, physically inactive, and overweight compared to whites. Additionally, African Americans participate in cardiovascular risk reduction behaviors such as diet control, exercise, and weight management at lower rates compared to individuals from other racial groups. Primary prevention of CVD through the adoption of healthy diet and physical activity behaviors is recommended to reduce the risk of developing CVD. According to health behavior theories, people must perceive themselves as susceptible to disease to adopt a preventive behavior. Few studies have examined psychological and sociocultural factors that influence cardiovascular risk perception in African Americans. As part of a randomized trial comparing the effects of integrated versus disease specific risk education in a community-based sample of African Americans, we (1) evaluated perceived risk of developing CVD and (2) identified factors having significant independent association with risk perception. The sample consisted of 199 African American adults who were on average 45.0 years (± 9.9) old. The participants were 53% male and 47% female. Approximately 23% of the participants were at intermediate or high risk for CVD. Most (83%) participants received medical care in a doctor’s office, clinic, or community health center and had a recent visit (≤ 1 year) to a doctor (84%). More than half (62%) of participants did not perceive themselves to be at increased CVD risk. In the multivariate model that controlled for age, objective risk (β=1.85, p=0.03), a family history of CVD (β=0.47, p=0.006), a recent doctor visit (β=1.90, p=0.03), and usual source of health care (β=-2.24, p=0.008) had a significant association with risk perception. Our results suggest that usual source of health care is important to perceived risk of developing CVD. This could be because provider interaction is important in appropriate CVD risk perception. Future research is needed to evaluate the content of patient-provider discussions about CVD in different settings.

Effects of an Office-Based Carotid Ultrasound Screening Intervention

Carotid ultrasound screening (CUS) has been recommended for cardiovascular disease risk prediction, but its effectiveness in clinical practice is unknown. The purpose of this study was to prospectively determine the effects of office-based CUS on physician decision making and patient health-related behaviors. Physicians from five nonacademic, community practices recruited patients aged ≥40 years with ≥1 cardiovascular disease risk factor. Abnormal results on CUS (AbnlCUS) were defined as carotid intima-media thickness >75th percentile or carotid plaque presence. Subjects completed questionnaires before and immediately after CUS and then 30 days later to determine self-reported behavioral changes. Odds ratios (ORs) for changes in physician management and patient health-related behaviors were determined from multivariate hierarchical logistic regression models. There were 355 subjects (mean age, 53.6 ± 7.9 years; mean number of risk factors, 2.3 ± 0.9; 58% women); 266 (74.9%) had AbnlCUS. The presence of AbnlCUS altered physicians' prescription of aspirin (P < .001) and cholesterol medications (P < .001). Immediately after CUS, subjects reported increased ability to change health-related behaviors (P= .002), regardless of their test results. Subjects with AbnlCUS reported increased cardiovascular disease risk perception (OR, 4.14; P < .001) and intentions to exercise (OR, 2.28; P= .008), make dietary changes (OR, 2.95; P < .001), and quit smoking (OR, 4.98; P= .022). After 30 days, 34% increased exercise frequency and 37% reported weight loss, but these changes were not predicted by the CUS results. AbnlCUS modestly predicted reduced dietary sodium (OR, 1.45; P= .002) and increased fiber (OR, 1.55; P= .022) intake. Finding abnormal results on CUS had major effects on physician but not patient behaviors.

Theoretical considerations in reducing risk for cardiovascular disease: implications for nursing practice

This article describes the theoretical foundation of risk perception as a key component of changing deleterious health behaviours associated with cardiovascular disease (CVD). Furthermore, perception in increasing cardiovascular risk-reducing behaviours in a socio-cultural framework is discussed, and an empirical development conceptual model presented. Perception of risk is strongly linked with health-seeking behaviours. Understanding how to reduce risk and maximise cardiovascular health is an increasing focus of clinicians, researchers and policy makers. Increasing cultural diversity in contemporary society means that nurses need to develop and evaluate interventions in this context. An integrative literature review. An integrative literature review method was used to assess conceptual models relating to risk perception of developing CVD. On the basis of the findings, a model was developed to inform future intervention studies, considering individual, social and cultural factors. Studies examining CVD and health behaviours report that there is limited concordance between actual and perceived risk in people with CVD. This mismatch risk likely impedes the adoption of risk-reducing behaviours. There is a critical need to develop interventions for enhancing an accurate perception of CVD risk considering not only individual but social factors. There is limited correlation between knowledge and behaviours, and health behaviours are influenced by individual, social and cultural factors. Appraising the congruence between actual and perceived risk is an important step in developing effective care plans to reduce cardiovascular risk.