Cardiovascular prevention and attitude of people towards behavior changes: state of the art

In recent years the main focus of cardiovascular prevention hasbeen to identify people without clinical evidence of coronary disease, but with a high risk ofdeveloping a clinical event. Long term follow up studies show that a young person with a high“Relative Risk” of presenting a cardiovascular event becomes an adult with a high “AbsoluteRisk” of suffering it. The aim of primary prevention is to avoid the appearance of cardiovasculardiseases, delaying the development of atherosclerosis and its consequences. In this scenario, thefirst step is to increase awareness among healthy people of their own cardiovascular risk,enhancing their knowledge of their risk parameter values and generating a correct perceptionof the risk burden that those values mean. Literature review reveals that significant percentagesof healthy individuals are unaware of their own values of blood pressure, total cholesterol andblood glucose. Furthermore, people aware of having abnormal parameters have low treatmentcompliance rates or evidence inconsistency between knowledge and behavior. This paperreviews educational strategies and other factors that influence this knowledge-behavior gap,such as the stages of behavior changes of the Prochaska and Diclemente Model. Evidence hasshown that knowledge about cardiovascular risk factors is not enough to influence behaviorand that the degree of preparation of people towards behavior changes is a strong predictor ofthe success of educational and counseling interventions. Local Chilean data from the RICARproject also shows that the profile of behavior change is different for each modifiablecardiovascular risk factor (Rev Med Chile 2006; 134: 223-30).(