Primary prevention of cardiovascular diseases in general practice: Mismatch between cardiovascular risk and patients' risk perceptions

T. Van Der Weijden, B. Van Steenkiste, H. E.J.H. Stoffers, D. R.M. Timmermans, R. Grol

Research output: Contribution to journalArticleAcademicpeer-review

68 Citations (Scopus)


Objective. Guidelines on primary prevention of cardiovascular disease (CVD) emphasize identifying high-risk patients for more intensive management, but patients' misconceptions of risk hamper implementation. Insight is needed into the type of patients that general practitioners (GPs) encounter in their cardiovascular prevention activities. How appropriate are the risk perceptions and worries of patients with whom GPs discuss CVD risks? What determines inappropriate risk perception? Method. Cross-sectional study in 34 general practices. The study included patients aged 40 to 70 years with whom CVD risk was discussed during consultation. After the consultation, the GPs completed a registration form, and patients completed a questionnaire. Correlations between patients' actual CVD risk and risk perceptions were analyzed. Results. In total, 490 patients were included. In 17% of the consultations, patients were actually at high risk. Risk was perceived inappropriately by nearly 4 in 5 high-risk patients (incorrect optimism) and by 1 in 5 low-risk patients (incorrect pessimism). Smoking, hypertension, and obesity were determinants of perceiving CVD risk as high, whereas surprisingly, diabetic patients did not report any anxiety about their CVD risk. Men were more likely to perceive their CVD risk inappropriately than women. Conclusion. In communicating CVD risk, GPs must be aware that they mostly encounter low-risk patients and that the perceived risk and worry do not necessarily correspond with the actual risk. Incorrect perceptions of CVD risk among men and patients with diabetes were striking.

Original languageEnglish
Pages (from-to)754-761
Number of pages8
JournalMedical decision making
Issue number6
Publication statusPublished - 1 Nov 2007


  • Cardiovascular diseases
  • Primary prevention
  • Risk communication
  • Risk perception
  • Risk score sheet
  • Risk tables

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