Cardiovascular risk unawareness is common in individuals admitting to cardiology outpatient clinics in Turkey: the CVSCORE-TR study

Cardiovascular “risk” is an abstract concept that is frequently misunderstood by the general public. However, correct estimation of one’s own cardiovascular risk is important as risk unawareness is associated with noncompliance with interventions aimed to reduce risk burden. Knowing the prevalence and factors linked with an increased probability of risk unawareness are therefore important to develop strategies aimed to increase risk awareness. <i>Aims.</i> To study prevalence of risk unawareness and to understand risk markers associated with risk underestimation and overestimation. <i>Design.</i> A total of 1716 participants were enrolled to the study in 33 centers across Turkey. Relevant demographic and clinical data were collected by direct interview. Cardiovascular risk of the participants was calculated using SCORE risk charts. <i>Results.</i> Ten-year risk for a fatal cardiovascular event was calculated as low in 633 (36.8%), intermediate in 513 (29.9%) and high-very high in 570 (33.2%) participants, respectively. According to these findings, 34.6% (<i>n</i> = 593) of the participants estimated their risk correctly, whereas 22.7% (<i>n</i> = 390) of the participants overestimated and 42.7% (<i>n</i> = 733) of the participants underestimated their risk. Male gender was the sole factor that was associated with an increased risk of underestimation, while having hypertension, significant valve disease or atrial fibrillation was associated with increased odds for risk overestimation. <i>Conclusions.</i> Only one-thirds of the sample was aware of their calculated risk for cardiovascular mortality and risk underestimation was the most common mode of risk unawareness, prompting concerns on the possible impact of the latter on adherence to the strategies aimed to reduce cardiovascular risk. Illustration summarizing study flow and main takeaways. Out of 1716 participants included to the present analysis, only one-third of the participants were aware of their risk. Of those who were unaware of their risk, roughly two-thirds underestimated and one-third overestimated their calculated risk. Several demographic and clinical factors were associated with a higher or lower odds for risk unawareness. See text for details.