Publication Date
1-1-2021
Journal
Circulation: Cardiovascular Quality and Outcomes
DOI
10.1161/CIRCOUTCOMES.120.006548
PMID
33435730
PMCID
PMC7855929
PubMedCentral® Posted Date
1-13-2022
PubMedCentral® Full Text Version
Author MSS
Published Open-Access
yes
Keywords
Aged, Atherosclerosis, Cardiovascular Diseases, Cohort Studies, Female, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Male, Middle Aged, Risk Assessment, Risk Factors
Abstract
BACKGROUND: Cardiovascular prevention guidelines use estimated 10-year atherosclerotic cardiovascular disease (CVD) risk based on the pooled cohort equations to guide treatment decisions and engage patients in shared decision-making. We sought to determine patient perceived versus actual risk of atherosclerotic CVD and associations with willingness for preventive therapy.
METHODS: We evaluated calculated and perceived CVD risk among 4187 patients across 124 sites in the Patient and Provider Assessment of Lipid Management Registry. Ten-year risk was assessed using the pooled cohort equations; risk relative-to-peers was determined based on age-, sex-, and race-based percentiles; and patient estimates of risk were assessed using patient surveys. Poisson regression models evaluated associations between risk estimates, statin use, and willingness to take prevention therapy.
RESULTS: Overall, there was no correlation between patients' estimates of their 10-year CVD risk and calculated 10-year risk (ρ=-0.01,
CONCLUSIONS: When asked, most patients overestimate their 10-year risk but hold an optimistic bias of their risk relative to age-, race-, and sex-matched peers. Providing accurate absolute risk assessments to patients without proper context may paradoxically decrease many patients' perceived risk of CVD, thereby disincentivizing initiation of CVD risk reduction therapy.
Included in
Cardiology Commons, Cardiovascular Diseases Commons, Community Health and Preventive Medicine Commons, Medical Sciences Commons
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