Several factors increase the risk of cardiovascular disease. Many of these we can influence ourselves through changes in lifestyle or preventive drug treatment. But people’s attitudes to prevention vary with their perceptions of cardiovascular disease. Health communication to support preventive measures therefore needs to take into account people’s illness perceptions.

Åsa Grauman and three colleagues conducted an online survey with 423 randomly selected Swedes aged 40 to 70 years. Participants were asked to answer questions about themselves and about how they view cardiovascular disease. They then participated in an experiment designed to capture how they weighted their preferences regarding health check results.

The results showed a wide variety of perceptions about cardiovascular disease. Women more often cited stress as their most important risk factor while men more often cited overweight and obesity. An interesting result is that people who stated that they smoked, had hypertension, were overweight or lived sedentary, tended to downplay that factor as less risky for cardiovascular disease. On the other hand, people who stated that they experienced stress had a tendency to emphasize stress as a high risk of cardiovascular disease. People who reported family history as a personal risk of illness showed a greater reluctance to participate in health examinations.

Regarding preferences about health check results, it was found that the participants preferred to have their results presented in everyday words and with an overall assessment (rather than, for example, in numbers). They also preferred to get the results in a letter (rather than by logging in to a website) that included lifestyle recommendations, and they preferred 30 minutes of consultation (over no or only 15 minutes of consultation).

It is important to reach out with the message that the risk of cardiovascular disease can be affected by lifestyle changes, and that health checks can identify risk factors in people who are otherwise asymptomatic. Especially people with a family history of cardiovascular disease, who in the study were more reluctant to undergo health examinations, may need to be aware of this.

To reach out with the message, it needs to be adapted to how people perceive cardiovascular disease, and we need to become better at supporting correct perceptions, the authors conclude. I have mentioned only a small selection of results from the study. If you want to see the richness of results, read the article: Public perceptions of myocardial infarction: Do illness perceptions predict preferences for health check results.

Pär Segerdahl

Written by…

Pär Segerdahl, Associate Professor at the Centre for Research Ethics & Bioethics and editor of the Ethics Blog.

Åsa Grauman, Jennifer Viberg Johansson, Marie Falahee, Jorien Veldwijk. 2022, Public perceptions of myocardial infarction: Do illness perceptions predict preferences for health check results. Preventive Medicine Reports 26, https://doi.org/10.1016/j.pmedr.2021.101683

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Exploring preferences