Frijling Bernard D, Lobo Claudia M, Keus Inge M, Jenks Kathleen M, Akkermans Reinier P, Hulscher Marlies E J L, Prins Ad, van der Wouden Johannes C, Grol Richard P T M
Centre for Quality of Care Research, University of Nijmegen/Maastricht, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
Patient Educ Couns. 2004 Jan;52(1):47-53. doi: 10.1016/s0738-3991(02)00248-3.
We aimed to examine risk perceptions among patients at moderate to high cardiovascular risk. A questionnaire about perceived absolute risk of myocardial infarction and stroke was sent to 2424 patients with hypertension or diabetes. Response rate was 86.3% and 1557 patients without atherosclerotic disease were included. Actual cardiovascular risk was calculated by using Framingham risk functions. A total of 363 (23.3%) of the 1557 patients did not provide any risk estimates and these were particularly older patients, patients with a lower educational level, and patients reporting no alcohol consumption. The remaining 1194 patients tended to overestimate their risk. In 42.3% (497/1174) and 46.8% (541/1155) of the cases, patients overestimated their actual 10-year risk for myocardial infarction and stroke, respectively, by more than 20%. Older age, smoking, familial history of cardiovascular disease (CVD), and actual absolute risk predicted higher levels of perceived absolute risk. Male sex, higher scores for an internal health locus of control, lower scores for a physician locus of control, and self-rated excellent or (very) good health were positively related to higher accuracy. In conclusion, patients showed inadequate perceptions of their absolute risk of cardiovascular events and physicians should thus provide greater information about absolute risk when offering preventive therapy.
我们旨在研究心血管疾病风险处于中高水平的患者的风险认知情况。一份关于心肌梗死和中风的感知绝对风险的问卷被发送给2424名高血压或糖尿病患者。回复率为86.3%，纳入了1557名无动脉粥样硬化疾病的患者。实际心血管风险通过使用弗明汉风险函数进行计算。1557名患者中共有363名（23.3%）未提供任何风险估计，这些患者尤其为老年患者、教育水平较低的患者以及报告不饮酒的患者。其余1194名患者往往高估了他们的风险。在42.3%（497/1174）和46.8%（541/1155）的病例中，患者分别将他们实际的10年心肌梗死和中风风险高估了20%以上。年龄较大、吸烟、心血管疾病家族史以及实际绝对风险预示着更高水平的感知绝对风险。男性、内部控制点较高的得分、医生控制点较低的得分以及自我评定为优秀或（非常）良好的健康状况与更高的准确性呈正相关。总之，患者对其心血管事件的绝对风险认知不足，因此医生在提供预防性治疗时应提供更多关于绝对风险的信息。
