Data from: Comparison of self-perceived cardiovascular disease risk among smokers with Framingham and Procam scores: a cross-sectional analysis of baseline data from a randomized controlled trial

Objectives: Previous studies suggest that smokers have a misperception of their 10-year cardiovascular risk. We aimed to compare 10-year cardiovascular risk self-perception and calculated risk among smokers willing to quit and assess the determinants of a possible misperception.
Design: Cross-sectional secondary analysis of baseline data from a randomized controlled trial of smoking cessation.
Participants: 514 participants, mean age 51.1 years, 46% women, 98% Caucasian. Eligible participants were regular smokers, aged between 40 and 70 years, with a consumption of at least 10 cigarettes per day for at least a year. None of them had experienced CVD before. Exclusion criteria comprised history of myocardial infarction, coronary heart disease (CHD), stroke, heart failure, peripheral vascular disease, carotid atherosclerosis or cardiac arrhythmia. Participants with renal or liver failure, psychiatric disorders, substance and alcohol abuse and with smoking cessation therapies were excluded.
Interventions: Participants were asked to estimate their 10-year cardiovascular risk using a 3-item scale corresponding to high, moderate and low risk categories. We compared their risk perception with the Framingham and Procam score. We used multi-variable adjusted logistic regression models to determine characteristics of participants who underestimate their risk vs. those who correctly or overestimate it.
Results: Between 38-42% of smokers correctly perceived their 10-year cardiovascular risk, 39-50% overestimated their 10-year cardiovascular risk while 12-19% underestimated it compared to their calculated 10-year cardiovascular risk depending on the score used. Underestimation of 10-year cardiovascular risk was associated with male gender (OR 8.16; CI 3.83-17.36), older age (OR 1.06; CI 1.02-1.09), and the presence of hyperlipidemia (OR 2.71; CI 1.47-5.01) and diabetes mellitus (OR 13.93; CI 3.83-50.66).
Conclusions: Among smokers, misperception of their 10-year cardiovascular risk is common, with one fifth underestimating it. These findings may help physicians target patients with such characteristics to help them change their health behavior and adherence to risk-reduction therapy.

研究目的：既往研究表明，吸烟者对自身10年心血管风险存在认知偏差。本研究旨在对比意向戒烟吸烟者的10年心血管风险自我感知与计算所得风险，并评估此类认知偏差的影响因素。
研究设计：针对一项戒烟随机对照试验的基线数据开展横断面二次分析。
研究对象：共纳入514名受试者，平均年龄51.1岁，女性占比46%，高加索裔占比98%。纳入标准为：规律吸烟者，年龄40~70岁，每日至少吸烟10支且烟龄至少1年，既往无心血管疾病（Cardiovascular Disease, CVD）病史。排除标准包括：心肌梗死、冠心病（Coronary Heart Disease, CHD）、脑卒中、心力衰竭、外周血管疾病、颈动脉粥样硬化或心律失常病史；同时排除合并肝肾功能衰竭、精神疾病、物质及酒精滥用者，以及正在接受戒烟治疗的受试者。
干预措施：要求受试者通过涵盖高、中、低三类风险等级的3条目量表评估自身10年心血管风险，并将其风险感知结果与弗雷明汉（Framingham）风险评分及普洛卡姆（Procam）风险评分进行对比。本研究采用多变量校正logistic回归模型，分析低估自身风险者与风险感知正确或高估者之间的特征差异。
研究结果：根据所采用的风险评分体系不同，38%~42%的吸烟者能够正确认知自身10年心血管风险，39%~50%的受试者存在风险高估，12%~19%的受试者存在风险低估。相较于实测的10年心血管风险，风险低估现象与男性性别（优势比OR=8.16，95%置信区间CI：3.83~17.36）、年龄更大（OR=1.06，95%CI：1.02~1.09）、合并高脂血症（OR=2.71，95%CI：1.47~5.01）及糖尿病（OR=13.93，95%CI：3.83~50.66）显著相关。
研究结论：在吸烟者群体中，10年心血管风险认知偏差现象较为普遍，约五分之一的受试者存在风险低估。本研究结果可帮助临床医师识别具有上述特征的人群，助力其调整健康行为并提升风险降低治疗的依从性。