CVD Risk Often Underestimated by Doctors, Patients

The results of a recent study suggest that doctors and patients often underestimate cardiovascular disease (CVD) risk.

For their study, the researchers assessed 1094 patients without known CVD and 57 doctors in Malaysia in 2014. Patient data, as well as patients’ perception of and doctors’ estimations of patients’ CVD risk, was collected in face-to-face interviews with a structured questionnaire.
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A total of 508 (46.4%) patients were classified as high-risk using the Framingham Risk Score (FRS) alone, and this number increased to 776 (70.9%) when diabetes was included as high risk.

Results of the study revealed that, compared with the reference FRS, patients’ CVD risk was correctly estimated by only 34.4% of patients and 55.7% of doctors. Furthermore, CVD risk among patients who were deemed as high-risk was underestimated by 85.6% of high-risk patients and 59.8% of doctors.

Factors associated with patient underestimation of risk included no family history of CVD (adjusted odds ratio [aOR] 2.705), smaller waist circumference (aOR 0.979), and ethnicity.

Among doctors, underestimation was often influenced by patient factors such as female sex (aOR 2.232), younger age (aOR 0.908), the absence of hypertension (aOR 1.731), the absence of diabetes (aOR 1.931), higher high-density lipoprotein levels (aOR: 3.546), lower systolic blood pressure (aOR: 0.970), and ethnicity.

“The majority of consultations occurring between doctors and patients are being informed by inaccurate cardiovascular risk estimation,” the researchers concluded.

—Christina Vogt

Reference:

Liew SM, Lee WK, Khoo EM, et al. Can doctors and patients correctly estimate cardiovascular risk? A cross-sectional study in primary care [Published online February 26, 2018]. BMJ Open. doi:10.1136/bmjopen-2017-017711.