Introduction: Accurate risk perception is critical for secondary prevention of stroke. Few studies have focused on perceived risk of a recurrent stroke among stroke survivors in a diverse population.
Methods: The Discharge Educational Strategies for Reduction of Vascular Events (DESERVE) trial tested the efficacy of a skill-based intervention on blood pressure reduction among stoke/TIA patients. Using baseline data from DESERVE, the relationship between patient demographics, health beliefs and risk perception was assessed. Risk perception was evaluated by the participant’s perception of their risk of having a stroke in the next 10 years using a scale of 0-10 (with 0 being extremely unlikely and 10 being extremely likely), which was then re-categorized into three levels of risk perception: underestimate (<2), accurate (2-4) and overestimate (>4). Risk perception of having a cold within the next 10 years was also collected as a comparison measure. Differences in risk perception across race-ethnic groups were assessed using Chi-squared tests.
Results: At baseline, 552 stroke/TIA patients were recruited for DESERVE (29.4% white, 35.6% black, 35.0% Hispanic). Overall, 53.4% of patients overestimated their risk; 30.7% underestimated their risk; and only 15.9% accurately perceived their risk of a recurrent stroke. Accurate risk perception for a second stroke was significantly lower than for a cold (15.9% vs. 35.2%, p=0.002). Hispanics were more likely to overestimate their stroke risk compared to non-Hispanics (59.6% vs. 50.2%, p=0.031). Additionally, people who agreed vs. disagreed with the statement “I worry about having a stroke,” were much more likely to overestimate their risk of a recurrent stroke (61.1% vs. 38.6%, p=0.000).
Conclusion: In this sample of mild stroke/TIA patients, only 15.9% accurately perceived their risk of recurrent stroke. Overestimation of risk was more common among Hispanics than non-Hispanics, which might be explained by the health belief of “fatalism” in Hispanic culture. Future interventions should focus on improving stroke risk perception, especially among Hispanics.