02291nas a2200145   4500000000100000008004100001100001400042700001500056700001600071700001500087245011100102250001500213520186600228020005102094       2015                            d1 aHeeley E.1 aThakkar J.1 aChalmers J.1 aChow Clara00aInaccurate risk perceptions contribute to treatment gaps in secondary prevention of cardiovascular disease  a2015/12/153 a<p>
BACKGROUND: All patients with cardiovascular disease (CVD) are at high risk of recurrent events. Despite strong evidence, large treatment gaps exists in CVD secondary prevention. We hypothesize that patient's self-perception and general practitioner's (GP) assessment of future cardiovascular risk may influence secondary prevention behaviors. DESIGN AND METHODS: We examined patient and practitioner's perceived risk and its relationship with the uptake of secondary prevention recommendations in adults with CVD participating in the Australian Hypertension and Absolute Risk Study (AusHEART). RESULTS: Among the 1453 participants, only 11% reported having a high absolute risk and 29% reported high relative risk of recurrent events. The GPs categorized only 30% as having a 5-year risk &gt;/=15%. After adjusting for covariates, hospitalization within the preceding 12 months was the only significant predictor of patients accurate risk perception. Conventional cardiovascular risk factors were predictive of the GP's risk estimates. Patients who accurately understood their risk reported higher smoking cessation rates (7%Vs3%, p=0.003) and greater use of antiplatelet, blood pressure lowering therapy and statins (p <!--= 0.01). However there was no relationship between GP's risk perception and secondary prevention treatments. CONCLUSION: Both patients and GPs have optimistic bias and under-estimate the risk of future cardiovascular events. Patient's accurate self-perception, but not GPs risk perception, was associated with improved secondary preventative behaviors. This suggests that helping patients understand their risk may influence their motivation towards secondary prevention. Providing support to GPs or programs to help patients better understand their risks could have potential benefit on secondary prevention behaviours.-->
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