Heart attack risk perception biases among hypertension patients: the role of educational level and worry

Risk biases such as comparative optimism (thinking one is better off than similar others) and risk inaccuracy (misestimating one's risk compared to one's calculated risk) for health outcomes are common. Little research has investigated racial or socioeconomic differences in these risk biases. Results from a survey of individuals with poorly controlled hypertension (N=813) indicated that participants showed (1) comparative optimism for heart attack risk by underestimating their heart attack risk compared to similar others, and (2) risk inaccuracy by overestimating their heart attack risk compared to their calculated heart attack risk. More highly educated participants were more comparatively optimistic because they rated their personal risk as lower; education was not related to risk inaccuracy. Neither race nor the federal poverty level was related to risk biases. Worry partially mediated the relationship between education and personal risk. Results are discussed as they relate to the existing literature on risk perception.     

What role do lay beliefs about hypertension etiology play in perceptions of medication effectiveness?

BACKGROUND: Some people take the disease label "hypertension" literally; leading to the belief that increasing relaxation instead of medication is the best treatment for this condition. We experimentally tested the effect of such underlying beliefs on ratings of interventions for hypertension and compared alternative communication strategies to increase medication effectiveness ratings. METHODS: Outpatients (N = 152) with a known diagnosis of hypertension read a vignette describing an asymptomatic condition and recommended treatment. Experimental factors were the disease label (Hypertension vs. Korotkoff's Syndrome) and type of argument designed to persuade the reader that medication is most effective (Causal vs. Correlational). MEASURES: Background measures included demographics, beliefs that stress causes health problems and trust in physicians. Outcomes were effectiveness ratings for interventions to treat the condition. RESULTS: Participants who read a vignette describing "Hypertension" rated "relaxing more" as significantly more effective than participants exposed to the same condition but with the unfamiliar "Korotkoff's Syndrome" label, [F(1, 141) = 5.22, p = .024]. However, medication, reducing salty foods and losing weight were rated as more effective than relaxing more. Intervention ratings did not differ by type of argument presented. There was a significant interaction of disease label and trust in physicians [F(1, 125) = 7.01, p = .009]. Individuals with low trust rated medication as significantly less effective when exposed to an unfamiliar disease label. CONCLUSIONS: This study confirms the effect of the hypertension disease label on ratings of different interventions for the condition. However, participants rated biomedically recommended interventions as more effective than those not endorsed.