Low Subjective Cardiovascular Disease Risk Perceptions among Hypertensive Patients in Addis Ababa, Ethiopia

Area of Science:

• Cardiology
• Public Health
• Health Behavior

Background:

• Accurate cardiovascular disease (CVD) risk appraisal is vital for hypertensive patients to guide timely behavioral changes and prevent adverse outcomes.
• Understanding CVD risk perception among hypertensive patients in Ethiopia is crucial but currently unknown.
• This study aimed to compare subjective CVD risk perception with objective risk assessment using the nonlaboratory Framingham Risk Score (nl-FRS).

Purpose of the Study:

• To compare subjective cardiovascular disease (CVD) risk perception with objective risk assessment using the nonlaboratory Framingham Risk Score (nl-FRS) in hypertensive patients in Ethiopia.
• To identify the extent of agreement and disagreement between perceived and objectively calculated CVD risk.
• To determine factors associated with inaccurate CVD risk perception, particularly underestimation.

Main Methods:

• A cross-sectional study design was employed.
• The Attitudes and Beliefs about Cardiovascular Disease Risk Questionnaire and the nl-FRS were utilized to measure subjective and objective CVD risk, respectively.
• Statistical analyses included kappa statistic for agreement, chi-square tests, and multinomial logistic regression to identify predictors of risk perception.

Main Results:

• A total of 377 hypertensive patients participated, with a mean age of 53.61 years and 51.2% males.
• The majority (58.62%) reported low subjective CVD risk perception, contrasting with a moderate objective risk (72.4%) calculated by nl-FRS.
• Poor agreement (kappa = 0.0002) was observed between perceived and objective risk, with 76% of patients underestimating their risk. Hypertension duration, physician visit frequency, and diabetes control predicted underestimation.

Conclusions:

• Hypertensive patients in Ethiopia exhibit inaccurate and low subjective perceptions of CVD risk compared to their moderate objective risk levels.
• Significant underestimation of CVD risk is prevalent, influenced by factors like hypertension duration and diabetes management.
• Targeted educational interventions focusing on hypertension and CVD risk factors are essential to enhance patient risk perception and mitigate adverse cardiovascular events.