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

Introduction: Cardiovascular disease (CVD) risk screening may rely partly o n self-report information. The accuracy of self-reporting in relation to th e actual risk factor status is insufficiently known. Design: Self-report (yes, no, don't know) of presence of hypertension, hype rlipidemia, and overweight: was compared to the corresponding risk factor d ata obtained by physical examination and blood analysis. The examinations c arried 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 sel f-report was 69% or higher for the other risk factors, with the exception o f hypertension in women, where it was 29%. Specificity was generally high, except for hyperlipidemia. Conclusion: On a population level, self-reports of hypertension, hyperlipid emia, and overweight provide a feasible selection instrument by which a sub population 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 presenc e or absence of risk factors needs to improve before self-reporting can be used as a reliable instrument in risk factor screening. (C) 1999 American J ournal of Preventive Medicine.