Being at risk for cardiovascular disease: Perceptions and preventive behavior in people with and without a known genetic predisposition

Abstract

This study compares and explains differences in perceptions of cardiovascular disease (CVD) risk and preventive behaviors in people with and without a known genetic predisposition to CVD. A cross-sectional study using two samples was performed. The first sample (genetic predisposition; n = 51) consisted of individuals recently diagnosed with familial hypercholesterolemia (FH) through DNA testing. The second sample (no genetic predisposition; n = 49) was recruited among patients with CVD-risk profiles based on family history of CVD, cholesterol levels, and blood pressure, registered at general practices. Participants filled out a postal questionnaire asking about their perceived risk, causal attributions (i.e. genetic and lifestyle), and about perceived efficacy and adoption of preventive behavior (i.e. medication adherence and adoption of a healthy diet and being sufficiently active). Perceived comparative risk, genetic attributions of CVD, and perceived efficacy of medication were higher in the "genetic predisposition" sample than in the "no genetic predisposition" sample. The samples did not differ on lifestyle attributions, efficacy of a healthy lifestyle, or preventive behavior. Individual differences in perceived risk, genetic attributions, perceived efficacy of medication, and adoption of a healthy lifestyle were best explained by family history of CVD. Our findings suggest that in people diagnosed with a single gene disorder characterized by a family disease history such as FH, family disease history may be more important than DNA information in explaining perceptions of and responses to risk.

The Agenda for Familial Hypercholesterolemia

“…These perceptions affect adherence to both lifestyle interventions and medications. 20,21 Studies assessing the quality of life (QOL) of treatment modality in FH patients are small with the exception of 1 Dutch study. All studies were conducted outside the United States and used different methods to assess QOL.…”

Risk Communication in Families of Children with Familial Hypercholesterolemia: Identifying Motivators and Barriers to Cascade Screening to Improve Diagnosis at a Single Medical Center

“…Previous studies have found that positive factors reported by adult FH patients include feeling a moral duty and wanting to protect relatives from physical harm (van den Nieuwenhoff et al 2007;Weiner and Durrington 2008). Negative factors include not feeling responsibility, wanting to protect relatives from psychological distress, insufficient knowledge of hereditary risk, and feeling little control over relatives' health behaviors (Benson et al 2016;Claassen et al 2012;Hardcastle et al 2015;Hollman et al 2006;Jenkins et al 2013;van den Nieuwenhoff et al 2007;Weiner and Durrington 2008).…”

Knowledge of Coronary Heart Disease Risk Factors among a Community Sample in Oman: Pilot study

“…9 Inherent psycho-cognitive factors such as the perceived risk of a disease or the importance of behavioural change as well as barriers to the adoption of preventative behaviours or CHD screening may contribute to lack of knowledge. 6,7,10 The population of Oman is currently approximately four million and life expectancy has recently increased (76.2 years in 2012 versus 73.3 years in 2010). 11,12 Lifestyle changes, including an increase in sedentary lifestyles and a greater caloric intake, have contributed to a rapid rise in the incidence of CHD; diseases of the circulatory system accounted for 32.5% of hospital deaths in Oman in 2012 versus 29.4% of hospital deaths in 2010.…”

“…5 Greater knowledge of CHD risk factors helps individuals to correctly assess their personal risk, motivates them to increase prevention-seeking behaviours and has been associated with increased action to lower risks. [6][7][8] Estimating knowledge of traditional CHD risk factors among a population is therefore crucial in the prevention and treatment of this condition and continues to serve as the baseline for most screening programmes. 9 Inherent psycho-cognitive factors such as the perceived risk of a disease or the importance of behavioural change as well as barriers to the adoption of preventative behaviours or CHD screening may contribute to lack of knowledge.…”