In a Robert Koch Institute survey of 3,271 adults, half with elevated heart risk judged it low

Researchers at the Robert Koch Institute led by Roma Thamm analysed survey data from 3,271 adults aged 35 to 69 in the GEDA 2022 study, according to the Publication server of the Robert Koch Institute (Robert Kock Institute). Participants had no diagnosis of heart attack or stroke. A non-clinical test estimated each person's absolute risk of a first heart attack or stroke within ten years, and the result was compared with the risk the person perceived doi.orgPublication server of the Robert Koch Institute (Robert Kock Institute)doi.orgOpen source ↗.

Calculated risk and self-assessment

Data were collected in standardised telephone interviews between June 2022 and January 2023. The questionnaire test, developed at the German Institute of Human Nutrition Potsdam-Rehbrücke, needs no blood values. It takes into account age, sex, smoking, diet, diabetes, hypertension and family history of cardiovascular disease. Risk was graded as low (below 5%), still low (5% to below 7.5%), elevated (7.5% to below 10%) and high (10% or more).

By the test, risk was low in 73.5% of adults, still low in 7.8%, elevated in 6.0% and high in 12.8%. In total, 18.8% fell into the elevated or high groups. In self-assessment, 28.7% perceived almost no risk, 45.3% a low risk, 20.4% a moderate risk and 5.6% a high risk.

The higher the test-based risk, the smaller the share who perceived almost none or only a low risk. Even so, half of those with an elevated to high calculated risk did so: 51.0% of that group, and 50.1% among those with a high risk by the test doi.orgPublication server of the Robert Koch Institute (Robert Kock Institute)doi.orgOpen source ↗.

Who underestimates risk

In both women and men, underestimation was associated with low education, better mental health and physical activity. Among those at higher risk, people with at least five hours of physical activity per week underestimated their risk more often than less active people. The analysis does not establish a causal effect of exercise or mental health.

The study is a cross-sectional analysis of survey data; later heart attacks and strokes were not observed. Some self-reported items, such as body weight, smoking and activity, may be inaccurate. Calculated and perceived risk were recorded in different categories, which limits direct comparison.

The authors conclude that people who underestimate their cardiovascular risk despite an unfavourable risk factor profile are a key target group for prevention doi.orgPublication server of the Robert Koch Institute (Robert Kock Institute)doi.orgOpen source ↗. The questionnaire test does not replace a medical examination.