【摘要】 目的 心血管疾病是我国重要的公共卫生问题,准确感知个人心血管疾病风险对及时干预和预防措施至关重要。该研究探讨了心血管疾病风险感知水平与客观计算风险之间的一致性,并分析不同风险感知类别在身体活动和健康饮食习惯上的差异。方法 采用便利抽样法,于2022年3月至8月在中国湖州市长兴县2个社区及杭州市1所医学院附属医院内分泌科及体检科,选取年龄在20至80岁之间,且无心血管疾病既往诊断史的患者进行调查。采用中文版心血管疾病风险态度与信念问卷评估患者的主观风险感知水平,客观风险则通过动脉粥样硬化心血管疾病风险预测模型计算。此外,还收集患者的基本信息、自我报告的身体活动情况和饮食习惯。结果 共有739例患者参与此研究,29.2%的患者能准确感知其心血管疾病发病风险,其中64.5%患者存在过度感知,6.2%患者为感知不足,50.0%的高风险患者过低地感知其实际风险。与准确感知组相比,60～80岁(OR=6.569)、饮酒(OR=3.059)以及高血压(OR=2.352)的患者更容易低估其心血管疾病发病风险。同时,40～<60岁(OR=2.462)和在职人员(OR=2.352)则更容易存在过度感知。风险低估组中患者身体活动达标率最低,但3组比较差异无统计学意义(χ~2=2.556, P=0.278)。具有健康饮食习惯患者的比例在风险低估组中也最低,且3组比较差异具有统计学意义(χ~2=10.310, P=0.006)。结论 心血管疾病发病风险感知偏差在心血管疾病患者中普遍存在,尤其是在高风险患者中更明显。风险低估组患者的身体活动达标率和健康饮食依从率最低。医护人员应重点实施个性化心血管疾病风险沟通策略,以提高患者风险感知的准确性。更多还原

【Abstract】 Objective: Cardiovascular disease(CVD) remains a significant public health challenge in China. Accurate perception of individual CVD risk is crucial for timely intervention and preventive strategies. This study aimed to determine the alignment between CVD risk perception levels and objectively calculated CVD risk levels, then investigate the disparity in physical activity and healthy diet habits among distinct CVD risk perception categories.Methods: From March to August 2022, a cross-sectional survey was conducted in Zhejiang Province using convenience sampling. Participants aged between 20 and 80 years, without prior diagnosis of CVD were included. CVD risk perception was evaluated with the Chinese version of the Attitude and Beliefs about Cardiovascular Disease Risk Perception Questionnaire, while objective CVD risk was assessed through the Prediction for Atherosclerotic Cardiovascular Disease Risk(China-PAR) model. Participants’ demographic information, self-reported physical activity, and healthy diet score were also collected.Results: A total of 739 participants were included in the final analysis. Less than a third of participants(29.2%) accurately perceived their CVD risk, while 64.5% over-perceived it and 6.2% under-perceived it.Notably, half of the individuals(50.0%) with high CVD risk under-perceived their actual risk. Compared to the accurate perception group, individuals aged 60-80 years old(OR = 6.569), currently drinking(OR = 3.059), and with hypertension(OR = 2.352) were more likely to under-perceive their CVD risk.Meanwhile, participants aged 40-<60 years old(OR = 2.462) and employed(OR = 2.352) were more likely to over-perceive their risk. The proportion of individuals engaging in physical activity was lowest in the under-perception group, although the difference among the three groups was not statistically significant(χ~2= 2.556, P = 0.278). In addition, the proportion of individuals practicing healthy diet habits was also lowest in the under-perception group, and a significant statistical difference was observed among the three groups(χ~2= 10.310, P = 0.006).Conclusion: Only a small proportion of participants accurately perceived their CVD risk, especially among those with high actual CVD risk. Individuals in the under-perceived CVD risk group exhibited the lowest rates of physical activity engagement and healthy diet adherence. Healthcare professionals should prioritize implementing personalized CVD risk communication strategies tailored to specific subgroups to enhance the accuracy of risk perception.更多还原