Self-report as a selection instrument in screening for cardiovascular disease risk

Introduction: Cardiovascular disease (CVD) risk screening may rely partly on self-report information. The accuracy of self-reporting in relation to the actual risk factor status is insufficiently known. Design: Self-report (yes, no, don’t know) of presence of hypertension, hyperlipidemia, and overweight was compared to the corresponding risk factor data obtained by physical examination and blood analysis. The examinations carried out in a primary health care setting in Sweden were on a randomized population of 122 men and 127 women aged 20 to 60 years. Results: Unawareness of hyperlipidemia was 71% in women and 56% in men, as compared to 29% or lower for the other risk factors. The sensitivity of self-report was 69% or higher for the other risk factors, with the exception of hypertension in women, where it was 29%. Specificity was generally high, except for hyperlipidemia. Conclusion: On a population level, self-reports of hypertension, hyperlipidemia, and overweight provide a feasible selection instrument by which a subpopulation with high risk factor frequency can be identified. However, the rate of misclassification is considerable. For hyperlipidemia, the benefit of self-reporting is presently limited, due to the high unawareness of this risk factor. Individual awareness and accurate knowledge about the presence or absence of risk factors needs to improve before self-reporting can be used as a reliable instrument in risk factor screening.