Presentation of new classification of perceived risk factors and etiologies of cardiovascular diseases.

To the Editor

Recently, a new classification of perceived risk factors of cardiovascular diseases (CVDs) has been suggested through assessment of a large number of cardiac rehabilitation patients. Based on this classification, Komasi and Saeidi divided the perceived risk factors and etiologies related to CVDs in five groups.1 Here, the details of this classification are explained, and this issue is discussed that this new classification belongs as a subgroup to which model of health field.

Based on self-regulatory model, patients form cognitive representations related to symptoms and treatment based on their perception of information derivate from their last longtime experiences, social environment, and present experiences. The representations of disease can affect on patients’ coping strategies and health behaviors.2 Based on this model, the disease perception has five dimensions: identification, cause (patient’s beliefs about the causes of disease), timeline, consequences, and control ability/curability.3 The second dimension of this model consists of perceived cause of disease that it assesses the perceived risk factors and causes in patients’ viewpoints.

Despite introduced components and instrument such as Illness Perceptions Questionnaire that they related to disease perception, recently a new classification has been presented for the perceived causes among cardiac patients.1 At first, according to this classification, perceived risk factors were divided into four groups titled biological, environmental, behavioral, and psychological factors.4,5 Then, one classification as titled physiological factors is added to others.1,6 According to results of two studies1,5 which assessed 1676 persons totally, 2.7%-4.3% of patients believe that biological risk factors as cause of their disease. In addition, 3.8%-4.4%, 31.7%-42%, 36.3%-39.2%, and 11.4% of patients present the environmental, behavioral, psychological, and physiological risk factors as cause of their disease, respectively.

According to this classification, perceived biological risk factors conclude of genetics and family history, age, gender, and ethnicity. The environmental risk factors include fume and toxin agents, dust, non-hygienic water, and passive smoking. The physiological risk factors consist of hypertension, diabetes, hyperlipidemia, and obesity. The behavioral risk factors include inappropriate nutrition, cigarette smoking and substance abuse, and heavy physical activity. The psychological risk factors include stress, grief and depression, anger and hostility, and partner’s misbehavior.1,6

It seems that this classification can promote the dimension of etiological perception related CVDs in format of self-regulation and it assesses the perceived risk factors of disease. Future studies about this new classification can indicate its efficacy and advantage in evaluation of beliefs and attitudes among cardiac patients about etiologies of disease.