Being at risk for heart disease affects perceived importance of own risk factors


How someone understands an illness also affects their attitudes to taking preventive action. A recent study investigated how Swedes aged 40 to 70 perceive the cause of heart infarctions and their beliefs about how much they can influence their own personal risk. 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 having those risk factors were less convinced about the casual link between their own risk factor and having a heart attack.

Åsa Grauman, Photo by David Naylor
Åsa Grauman, photo by David Naylor

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, that the study shows how people’s perception of cardiovascular disease varies. It is affected by your age, gender, their health literacy and, interestingly also whether they 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 affects their willingness to participate in health checks. And 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. But 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 on 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 that reported having a risk factor themselves, like smoking, hypertension, obesity and lack of physical activity, tended put less emphasis on that specific risk factor than other participants did. Remarkably, the opposite was found for stress. Participants that reported having 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 for developing methods to promote accurate illness perceptions by emphasising that there are things that the individuals can do themselves to decrease the risk of having a heart infarction. Increasing health literacy as 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 through by 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,” Åsa Grauman concludes.

Want to know more? Read the paper in Preventive Medicine Reports! 

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 januari (Open Access) DOI: 101683;

By Josepine Fernow

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Last modified: 2022-01-10