The association between perceived risk and actual cardiovascular disease.

We examined the association between self-rated risk of stroke or myocardial infarction and actual morbidity and mortality by gender among participants of the Pawtucket Heart Health Program Health Survey in a nested case-control study. We defined cases (N = 191) as survey participants who later had a cardiac event registered in the Pawtucket Heart Health Program cardiovascular disease morbidity and mortality surveillance system. We matched controls (N = 573) on age, sex, date of survey, and city of residence. Women reporting a high perceived risk of stroke or myocardial infarction were four times as likely as women who indicated low perceived risk to have a future cardiovascular event [adjusted odds ratio = 4.0; 95% confidence interval (CI) = 1.5-10.3]. Men who perceived their risk as average were twice as likely as those who rated their risk as low to have a future myocardial infarction or stroke (adjusted odds ratio = 1.9; 95% CI = 1.0-3.6), whereas those who perceived their risk as high were at only slightly higher risk of morbid or mortal events (adjusted odds ratio = 1.8; 95% CI = 0.9-3.9).