Unequal knowledge about cardiovascular diseases

Although many people know what increases the risk of cardiovascular diseases, such as heart attacks, not everyone recognises their own risk factors. This is shown by a new study of 423 Swedes aged 40–70 years, which has now been published in the scientific journal Preventive Medicine Reports.

How people perceive an illness also affects their attitudes to taking preventive action. A study investigated what Swedes aged 40 to 70 know about the causes of heart attacks and their beliefs about how much they can influence their own personal risk. The results show a high level of awareness among the participants about the causal impact of risk factors such as obesity, hypertension, smoking and lack of exercise on heart disease. However, people with those risk factors were less convinced about the causal link between their own risk factor and having a heart attack.

The survey looked at a random sample of 423 members of the Swedish public. According to Åsa Grauman, lead author of the Preventive Medicine Reports paper, the study shows how people’s perception of cardiovascular disease varies. It is affected by their age, gender, their health literacy and, interestingly, whether they personally have known risk factors for heart disease.

“A person’s ability to find, understand and use health information, and make decisions based on that information, affects their attitudes. This is important, because the results also showed that the way an individual perceived illness affected their willingness to participate in health checks. It also impacts how they want to receive test results from such health checks,” says Åsa Grauman, postdoc at Uppsala University’s Centre for Research Ethics & Bioethics.

Participants saw smoking, hypertension and obesity as the most important causes of myocardial infarctions, more commonly known as heart attacks. However, about a fifth of the respondents were unaware of the fact that diabetes is a risk factor for cardiovascular disease. Gender had no effect on the view of the most important risk factor for cardiovascular disease when it came to their own health. However, more women indicated stress as the most important risk factor, while men tended to pick overweight/obesity. Respondents who reported having a risk factor themselves, like smoking, hypertension, obesity or lack of physical activity, tended to put less emphasis on that specific risk factor than other participants did. Remarkably, the opposite was found for stress. Participants who reported higher levels of stress tended to also emphasise stress as a risk factor for heart disease.

According to Åsa Grauman, the results point to the importance of addressing people’s perceptions of an illness when designing health communication and preventive interventions. For instance, the results show that individuals that perceive low personal control over their risk of having a heart attack were less willing to receive lifestyle recommendations. This means adapting the design of health checks and the way test results are shared with participants afterwards. But it also points to the need to develop methods to promote accurate illness perceptions by emphasising that there are things that individuals can do themselves to decrease the risk of having a heart attack. Increasing health literacy is a means of encouraging people to take preventive action and avoid risks in their everyday lives.

“The most important take-home message from this study is that the risk of cardiovascular disease can be modified and improved by lifestyle changes. This is also true, and perhaps even more important, for people with a family history of cardiovascular disease. This is the message we need to communicate to the public,” says Åsa Grauman.

Grauman Å, et al; Public perceptions of myocardial infarction: Do illness perceptions predict preferences for health check results, Preventive Medicine Reports, volume 26, April 2022, online 25 January (Open Access) DOI: 101683; https://doi.org/10.1016/j.pmedr.2021.101683

Further information:

Åsa Grauman, Postdoc at Department of Public Health and Caring Sciences, Centre for Research Ethics & Bioethics (CRB) at Uppsala University, email: asa.grauman@crb.uu.se, phone: 073-330 59 78

Previous research by Åsa Grauman:

Åsa Grauman, Jorien Veldwijk, Stefan James, Mats Hansson, Liisa Byberg, Good general health and lack of family history influence the underestimation of cardiovascular risk: a cross-sectional study, European Journal of Cardiovascular Nursing, Volume 20, Issue 7, October 2021, Pages 676–683, https://doi.org/10.1093/eurjcn...

Communicating Test Results from a General Health Check: Preferences from a Discrete Choice Experiment Survey (Patient, 2021) DOI: 10.1007/s40271-021-00512-4, https://pubmed.ncbi.nlm.nih.go...

Exploring research participants' perceptions of cardiovascular risk information – Room for improvement and empowerment, (Patient Education and Counseling, 2019) DOI: 10.1016/j.pec.2019.03.010, https://pubmed.ncbi.nlm.nih.go...

Short-term mental distress in research participants after receiving cardiovascular risk information (PLOS One 2019) DOI: 10.1371/journal.pone.0217247, https://journals.plos.org/plos...

The publics’ perspective on cardiovascular risk information: Implications for practice, (dissertation, Uppsala University 2021), http://urn.kb.se/resolve?urn=u...