Appendix A.

Evidence table

Authors; Year of Publication; Setting; Study Design	Sample	Purpose; Study Protocol/Measures	Results
Tamragouri et al., 1986 USA Cross-sectional, comparative study	Group One: 69 freshmen with a FH of CVD; 55% female Group Two: 155 freshmen without a FH; 50.6% female Mean age of sample and race/ethnicity not provided	To compare the cardiovascular health knowledge and health behaviors between college freshmen with and without a FH of CVD Questionnaires with Iowa Cardiovascular Health Knowledge Test, demographics, family characteristics, selected health behaviors, and efforts to acquire health information	Cardiovascular Health Knowledge was low in both groups (18 of 35 questions were incorrectly answered by at least 40% of each group) with no differences between the two groups Students with a FH exercised less (OR=0.38; 90% CI: 0.16-.0.91) and were more likely to feel overweight (OR=1.73; 90% CI: 1.02–2.94) compared to students without a FH Students with a FH were not more likely to eat a low-fat diet (OR=1.85; 90% CI: 0.79–4.35), made no extra effort to receive health education (OR=1.21; 90% CI: 0.90–1.62), were more likely to smoke (OR=1.22; 90% CI: 0.61–1.62), and were less likely to have their cholesterol measured (OR=0.63; 90% CI: 0.29–1.38) compared to students without a FH Note: These differences were not statistically significant
Brorsson et al., 1995 Sweden Qualitative study	63 male participants, 35–45 year-old, diagnosed with moderate hypercholesterolemia (6.5–7.7 mmol/l)	To study the traits and relationship between FH and perceived risk in males with moderate hypercholesterolemia Lifestyle counseling session were audio-taped, transcribed and analyzed Session occurred after participants were newly diagnosed	45% (n=28) mentioned their FH during the counseling session 9% (n=6) specifically mentioned that CHD was part of their FH Fatal events, non-fatal conditions (symptoms of CHD), and premature deaths also emerged as themes that influenced perceived risk Note: The authors assumed that the participants perceived themselves at risk after the diagnosis of hypercholesterolemia (actual perceived risk was not measured)
Marteau et el.; 1995 United Kingdom Baseline, descriptive data from an RCT	3725 participants screened as part of the British Family Heart Study 2246 men (mean age of 50.11) and 1604 (mean age of 47.8) women Race/ethnicity not provided	To examine how individuals perceived their risk for CHD prior to screening To assess the degree of similarity between perceived risk and epidemiologically derived risk score Self-assessed 15-year heart attack risk “… compared with other people of your age and sex?” Epidemiologically-assessed risk based on: years smoking cigarettes, systolic BP, cholesterol level, diagnosis of CHD, diabetes, angina, and FH	Perceived Risk 964 participants had at least 1 FDR with CHD before age 65; 25% of these individuals perceived their heart attack risk as lower than average 1071 participants had a parental death from CHD; 27.4% of these individuals perceived their heart attack risk as lower than average 488 participants had a BMI >30; 25.8% of these individuals perceived their heart attack risk as lower than average 665 participants had total cholesterol > 251mg/dL (6.5 mmol/L); 32.5% of these individuals perceived their heart attack risk as lower than average Self-assessed risk of CHD was strongly positively associated with quintile (epidemiologically-based) risk (p<.001)
Ponder et al., 1996 United Kingdom Descriptive study	58 teenagers (23 males and 35 females; mean age of 16.8; range 16–18) 54 of their parents (19 fathers and 35 mothers, with a mean age of 46.5, range 36–74)	To examine the extent to which people take account FH when considering their susceptibility to health risks Interviews with teenagers and parents; same protocol for both Two-part interview: Part 1: Participant was asked, “Compared to other people of your age do you feel that you are more likely to get heart disease, or the same?” Part 2: Taking a FH history and drawing a family tree	Perceived risk 41% (n=46) of participants thought they were more likely than their peers to get HD 30% (n=34) reported being equally likely than their peers to get HD 29% (n=32) reported that the likelihood was unknown There were no significant differences in perceived risk between males and females and between the two generations Reason why they were more likely to develop HD 70% (32 of 46) cited their FH 39% (18 of 46) cited the environment 30% (14 of the 46) cited their personal actions FH Teenagers reported fewer relatives in general compared to the parents Parents knew more details (age of relatives, presence or absence of diseases, age at death) about relatives There was a significant difference between teenagers and adults in number of family members reported as having had heart disease (p<0.005)
Allen & Blumenthal, 1998 United States Cross-sectional, descriptive study	87 apparently healthy off-spring (56 daughters and 31 sons) of women with premature CHD Mean age of 37 (SD ± 7 years), 72% Caucasian	To examine coronary risk factors, related knowledge, attitudes, and beliefs concerning CHD risk Questionnaires, physical examination, and CHD risk biomarkers	Risk Factors 13% had only one major risk factor, a FH of premature CHD: 10% had two risk factors; 23% had 3; 54% had 4 or more CHD risk factors 51% offspring had total and LDL cholesterol levels above recommended levels for primary prevention 31% were current smokers 56% exercised fewer than three times a week 48% were overweight HD Knowledge Offspring most frequently mentioned dietary factors (76%), smoking (47%), lack of exercise (34%), and stress (34%) as the major causes of HD 25% mentioned high blood cholesterol and 28% cited heredity as an important factor in the development of heart disease Health beliefs and behavior 75% reported their health as very good or excellent In the past year, 26% said they had improved their eating habits, and 15% reported increasing exercise 63% said they were trying to lose weight 47% hoped to increase their exercise, 33% wanted to lose weight, and 23% planned to improve their eating habits over the next year to improve their health Perceived Risk 47% perceived their risk for future heart attack as less than or equal to others their age 58% rated their concern about future heart attack as an average or below average level of concern No significant relationship between perceived risk and actual risk based on the Framingham risk score equation Of those at increased risk based on their actual risk score, only 54% perceived themselves to be at any greater risk than others their age and gender
Ayanian & Cleary, 1999 United States Cross-sectional, descriptive study	737 current smokers (54.6% female; 83.7% Caucasian) Mean age 42.6	To assess smokers perceived risk for MI Self-reported smoking status and numbers of cigarettes smoked daily Self-assessed risk compared to people of the same age and sex	Only 29% of smokers perceived their MI risk as higher than persons of the same age and sex Among smokers with a FH of MI, 39% viewed their risk as higher than persons of the same age and sex
Hunt et al., 2000 United Kingdom Cross-sectional, descriptive study	Three cohorts originally recruited in 1987/88 The youngest cohort was around 23 years old (n = 676), the middle cohort was around 43 years old (n = 754), and the oldest cohort was around 63 (n = 732) Majority of the study participants were female (53% in the youngest cohort, 56.1% in the middle cohort, and 55.7% in the oldest cohort)	To examined the relationship between FH of HD and health-related attitudes and behavior Data used in the study were collected in 1995/96 Nurses collected information designed to explore the relationship between perceptions of FH of illness, health attitudes, health-related behaviors, and asked questions about the health and deaths of family members	FH Approximately 20% of the participants in each cohort reported a FH of HD Perception of a FH of HD was significantly related to the number of relatives they reported as having HD (p<0.0001) However, in each cohort, 40% to 52% of the individuals with two parents or siblings with HD did not report a FH of HD The percentage was higher, 56% to 83%, for individuals with the only 1 parent or sibling with HD In the two older cohorts, women were significantly more likely to report a FH of HD (15% of males vs. 25% of females in the middle cohort; p<0.001 and 16% of males vs. 23% of females in the oldest cohort; p<0.05) Perceived heart disease risk Individuals in each cohort with a reported history of HD were about twice as “likely to get HD” compared to individuals without a reported history of HD (p<0.001) Individuals with a reported history of HD felt that “family illness” played a greater role in the etiology of HD compared to individuals without a reported history of HD (p< 0.001 in the youngest cohort, p< 0.01 in the middle cohort, and p< 0.001 in the oldest cohort) Health promotion In the youngest cohort only, individuals with a reported FH of HD were more likely to “strongly agree” or “agree” that not smoking and exercising is important if “HD runs in someone’s family” compared to individuals with no reported FH of HD (95% vs. 87%; p<0.001 for smoking and 95% vs. 88%; p<0.001 for exercise) In all cohorts, there were no significant differences between individuals with a reported FH of HD compared to those with no reported history of HD regarding the importance of a healthy diet
Kavanagh et al., 2000 Canada Cross-sectional, descriptive study with a 2 year follow-up questionnaire	571 sons of men with a premature coronary event Mean age 32.1 (SD ± 7.1) Race/ethnicity not provided	To determine the modifiable risk factors in the male offspring of patients who had a premature coronary event To assess the extent of personal health initiatives being taken by the offspring To estimate, from the perspective of the offspring, the degree to which their family physicians had promoted a healthy lifestyle and carried out risk-reduction counseling Questionnaires: medical history, lifestyle, knowledge of health status and risk factors, and interaction with the family physician Lipid panel drawn	Risk Factors The prevalence of cardiac risk factors were high: 48% had less than optimal cardiovascular fitness, 34% were overweight, 46% had total cholesterol ≥ 200 mg/dL, 26% had HDL cholesterol ≤ 35 mg/dL, and 16% had LDL cholesterol ≥160 mg/dL (16%) Perceived Risk 41.5% of respondents rated their level of concern about their health as “high” Healthy Lifestyle 23% were currently cigarette smokers and 25% exercised regularly 47.8% attempted to eat a low fat diet, 46% tired follow a regular exercise regimen, and 50.2% attempt to maintain appropriate body weight Interaction with family physician 90.5% of the offspring had a family physician whom they saw on a regular basis (average 1.8 times the previous year and 4.7 times over the previous 3 years) 53% had their blood lipids checked and of these, only 9.5% were advised of the actual measurement 11% were advised on a low-fat diet and were 18% recommended exercise Of the 58 subjects with known hypercholesterolemia, 35 (60%) received counseling on a low-fat diet
Hunt et al., 2001 United Kingdom Qualitative study	Purposive sampling of 61 men and women who participated in the 1996 Midspan Family Study “Roughly equal numbers of men and women from middle class and working class” Between the ages of 40–49 during the 1996 survey	To explore which factors affect whether people regard themselves as having a FH of CHD or not Semi-structured interviews Questions in the interviews covered why some people have more illnesses than others, beliefs about HD, FH of illness or weaknesses, construction of FH tree, and discussion of inheritance in the broadest sense	Genes, or heredity, were mentioned as a cause of HD by more than two-thirds of the respondents Perception of a FH of HD depended on knowledge of the health of family members, the number and closeness of relatives with heart conditions, and the age of affected relatives Women usually gave more detailed accounts than men and needed less encouragement Men, particularly working-class men, required a greater number of close relatives to be affected to perceive that they had a FH Even when respondents judged that HD ran in their family, they did not always perceive themselves as at increased risk because they felt different in crucial ways from their affected relatives
Kip et al., 2002 United States Longitudinal, descriptive study	3950 participants; 77% of total cohort originally approximately equally distributed by age, race/ethnicity, gender, and education	To examine if the occurrence of a heart attack or stroke in an immediate family member had an impact on CVD risk factors in young adults Smoking, physical activity, lipids/lipoproteins, body weight, and blood pressure were recorded over two consecutive 5-year follow-up periods Occurrence of a heart attack or stroke in an immediate family member of the participants was recorded between Year 0 (baseline) and Year 5 and between Year 5 and Year 10	After adjusting for baseline demographics and risk factors, young adults who experienced a change in FH of heart attack or stroke over a 5-year period were no more likely to quit smoking or to experience more positive changes in weight, physical activity, LDL cholesterol, HDL cholesterol, triglycerides, or systolic or diastolic BP compared to young adults without a change in their FH
Montgomery et al., 2003 United States Cross-sectional, descriptive study	522 participants; 62% female and 56% Caucasian Mean age: 39.61 (SD ± 15.29)	To examined if a FH of disease contributes to perceived risk, if a history of disease in a friend or non-blood relative increases perceived risk, and if these effects are similar across genders Participants completed a Health Assessment Personal Protocol Inventory, which included items to assess demographic variables, perceived risk, personal and FH of HD Participants were also asked if they had a friend or non-blood relative with each disease (Friend History)	For both men and women, a positive FH of HD was associated with higher levels of perceived risk for HD (p<0.0001) Women only: a positive history of HD in a friend was associated with higher levels of perceived risk for HD (p<0.0001)
Astin & Jones, 2004 Australia Descriptive study	141 subjects (108 males) Mean age 63 (SD ± 10.9) 90% European ethnicity	To compare patients’ perceived causal attributions for CHD between males and females Semi-structured interviews to elicited information about causal attributions; BMI was recorded at the time of the interview Data about coronary risk factors were extracted from the medical records	Women more frequently cited FH as the cause of their CHD (41% vs. 28%; p=.001) A greater proportion of males than females attributed their illness to behavioral (controllable) causes rather than to biological causes (51% vs. 23%; p<.001) A greater proportion of females than males attributed their illness to biological (uncontrollable) causes (42% vs. 24%; p=.04)
Kelley et al., 2004 United States Cross-sectional, descriptive, comparative study	297 participants from the Coronary Artery Risk Detection in Appalachian Communities (CARDIAC) Project All participants were Caucasian, 53% were female, the average age was 10.8 (SD ± 0.6) years for boys and 10.6 (SD ± 0.7) years for girls	To examine if children who were at high-risk for CVD based on FH would have different diets than children from low-risk families All participants were screened for FH of early CVD; had their height, weight, and fingerstick total cholesterol measured; and filled out a 151-item food frequency questionnaires	Children at risk for CVD 68 (23%) children at risk for CVD based on National Cholesterol Education Program guidelines Mean non-fasting cholesterol was significantly greater in the at-risk group compared with the not-at-risk group (4.71 SD ± 0.93 mmol/L vs. 4.35 SD ± 0.92 mmol/L; p=.005). There were no differences in BMI or BP between the two groups Health Promotion There were no differences between groups in intake of macronutrients, fiber, cholesterol, or percentage of calories as fat Percentages of calories as fat and saturated fat were higher than recommended for both groups
McCusker et al. 2004 United States Cross-sectional, descriptive study	3383 respondents without a personal history of stroke, heart attack, angina, or CHD 63% were female, 75% were Caucasian, 35% were between the ages of 35–44, and 36% were between the ages of 45–64	To examine the association between FH–based HD risk and CVD risk-reducing behaviors Data from the 2001 Healthstyles survey, a cross-sectional survey of health attitudes, behaviors, conditions, and knowledge, was used The authors compared individuals with no reported FH of CVD (average risk) to individuals with one reported relative with a history of CVD (moderate risk) and individuals with two or more reported relatives with a history of CVD (high risk)	Risk Classification 57% were classified as having average HD risk 28% were classified as being at moderate HD risk 18% were classified as being at high HD risk Health Promotion After adjusted for age, there were no differences between the average risk group and the combined moderate/high risk group in cutting back on high-fat foods, increasing consumption of fruits and vegetables, increasing physical activity, or trying to stop smoking (among smokers only) The two groups did differ by serum cholesterol measurement (p<0.01) and aspirin use (p=0.02)
DeSalvo et al., 2005 United States Baseline, descriptive data from an RCT	128 African American women Mean age 56 (range 35 to 86)	To describe the personal characteristics associated with underestimating CVD in black women Objective risk was determined by counting major cardiac risk factors Perceived risk determined by a survey question about personal cardiac risk	This sample had a high prevalence of cardiac risk factors: 77% were obese; 72% had hypertension; 48% had high cholesterol; 49% had a FH of heart disease; 31% had diabetes, and 22% currently used tobacco Seventy-nine percent had 3 or more cardiac risk factors and were at high risk; 63% of these individuals did not perceived themselves to be at risk for HD Among all patients, objective and perceived cardiac risk was poorly correlated
Walter & Emery, 2005 & 2006 Qualitative study	30 participants (53% females) 40% of were between 20–39 years old, 47% were between 40–59 years old, and 13% were older than 60 years old 93% were Caucasian and 87% married 50% had a FH of heart disease, 47% had a FH of cancer, and 23% had a FH of diabetes	To explore how individuals understand and come to terms with their FH Interviews were conducted with general practice patients who had a FH of cancer, HD, or diabetes The recorded and transcribed data underwent a qualitative constant comparative analysis	Feeling at risk There are multiple routes to feeling at risk The emotional impact of witnessing a relative’s illness, recovery, or death contributes to the individual perception of personal risk The course of the illness contributed to the perception Premature or sudden death adds to the perception of risk more significantly than death in the 60s or 70s. The survival and return to a normal lifestyle, which often occurs in CHD, results in the FH of heart disease being less threatening Participants looked for patterns within their FH when considering their own risk including: life events, age of onset of the illness, and the sex of the family members affected Taking control of the threat Participants attempt to take control of the threat of their FH by changing behavior, taking medication, participating in screening, and obtaining information about the disease Notions of fatalism sometimes countered their beliefs in the ability to control their disease risk Participants reported a greater sense of empowerment over a FH of HD and diabetes compared to cancer The availability of medications and surgeries to manage HD added to the participants’ sense of control over their FH
Thanavaro et al., 2006 United States Correlational cross-sectional design	119 women Mean age 49.4 (SD ± 6.7) 78% Caucasian	To determine HPB and the best predictors of HPB in women without prior history of CHD Study measures: demographic information, perceived CVD risk factors, HPLP II, CHD knowledge, the Benefits Scale, and the Barriers Scale	The sample did not practice HPB regularly (based on the HPLP II) and had low CHD knowledge levels, a high perception level of benefits, and a moderate level of perceived barriers to CHD risk modification Backward multiple regression analysis demonstrated that FH of CHD (p=.05), CHD knowledge levels (p=.005) and perceived barriers to CHD risk modification (p<.001) were the best predictors of HPB in women without CHD
Patel et al., 2007 United States Cross-sectional, descriptive, comparative study as part of the Dallas Heart Study	2404 subjects (1327 women and 1077 men) between the ages of 30 and 50 (mean age of 40) 52% of the women and 47.7% of the men were African American	To examine the role of a FH of premature MI on CVD risk factor burden, atherosclerosis, and risk awareness in young men and women Individuals who did not know or were unclear about their FH were considered has having no FH of premature MI Information about perceived lifetime risk of MI, tobacco use, and physical activity were collected by questionnaire CAC was measured with Imatron 150 XP scanners	FH Women were more likely to report a FH of premature MI compared to men (12.4% vs. 9.3%; p=0.014) In women only, a FH of premature MI was associated with an increased composite risk factor burden (defined as having ≥ 2 traditional CVD risk factors) compared to women without a FH (49.1% vs. 39.1%; p=.001) In women only, a FH of premature MI was independently associated with CAC among women (adjusted OR=2.0; 95% CI: 1.0–4.1) Perceived Risk In both men and women, individuals with a FH of premature MI perceived their lifetime risk of MI to be greater than average (in women, 59.7% vs. 47.4%; p=.001 and in men, 75.0% vs. 48.3%; p=.004) Health Promotion Women with a FH of premature MI were more likely to smoke than those without a FH (p<.001) Men with a FH premature MI were less likely to be sedentary than men without a FH (p=.001)
Andersson et al., 2009 Sweden and Poland Cross-sectional, descriptive study	2054 total participants 1,043 (624 females, 419 males) from Poland 1,011 (554 females, 457 males) from Sweden All participants were 50-years old	To examine how a personal experience of illness and FH of CVD affect risk behavior FH, personal experience of illness and risk behavior (smoking and exercise habits, BMI) were self-report	FH 21% (n=424) of all participants had a FH of CVD (27% of all Polish participants vs. 14% of all Swedish participants; p<0.002) Personal experiences of CVD 19% (n=388) of all participants had a personal experience of CVD (27% of all Polish participants vs. 10% of all Swedish participants; p<0.001) Health Promotion A personal experience of CVD resulted in less smoking (OR=1.48; 95% CI: 1.14–1.93), but a FH of CVD did not (OR=0.84; 95% CI: 0.66–1.07) Neither a personal experience of CVD or a FH of CVD predicted more physical exercise Participants with a personal experience of CVD or a FH of CVD were more obese compared to participants without a personal experience or FH (p<0.001 and p=0.002 respectively)
Slattery et al., 2009 United States Baseline data from a prospective, observational study	10,374 American Indian and Alaska Native people 6489 females Mean age of 39.9 (SD ± 14.4) for all participants	To examine the prevalence of self-reported FH of heart attack and stroke among a cohort of American Indian and Alaska Native people To evaluate the association between having a positive FH among FDR and health behaviors Study measures: health and lifestyle questionnaire that included physical activity, medical conditions, and family health history Medical tests included BP, height, weight, and serum lipid and glucose levels	FH Over 50% of participants preferred not the answer the FH section of the questionnaire (23.5%) or did not know their FH of HD (29.7%) or stoke (32%) Among those who knew their FH, 25% reported a FH of heart attack, and 22.1% reported a FH of stroke Of those who reported the age at diagnosis of their family members, 56.6% reported female relatives younger than 60 years and 36.7% reported male relatives younger than 50 years at diagnosis for heart attack (actually numbers not provided in manuscript) Women were more likely than men to know their FH and to be willing to complete the questionnaire; education was strongly associated with completing the FH section: participants with a college degree were more likely than those with less than a high school education to know their FH Health Behaviors Participants with a FH of heart attack or stroke tended to have a higher BMI (p<.001), report less vigorous physical activity (p<.001), have higher total serum cholesterol (p<.001) and LDL cholesterol (p<.001) than those without a FH of heart attack or stroke
Acheson et al., 2010 United States Cross-sectional, descriptive study	2,330 participants completed the study questionnaires 71% were women and were 91% Caucasian Participants’ age ranged from 35–65 years (mean age of 50 years)	To determining if FH was related to patients’ perceptions of risk, worry, and control over getting six diseases First, participants completed online questionnaires measured demographics, self-reported health status, personal risk factors, and health perceptions for each of the six diseases Secondly, the participants used the web-based Family Healthware questionnaire to record their detailed family medical history Based on the data collected, familial risk for each disease is summarized as weak (similar to general population risk), moderate (having one FDR with the disease), or strong (having more than one FDR with the disease)	Participants rated their level of perceived risk for CHD as 2.71 (on a scale of 1–5), which corresponded to the response “about the same as average” Results were similar for stroke (2.65 on a scale of 1–5) The majority of people determined to be at increase risk for HD and stroke based on the Family Healthware algorithms did not consider themselves to be at increased risk For CHD, 30% of individual actually in the “moderate” and “strong” risk categories perceived their risk as being at above or much above the average risk For stroke, only 21% of the individuals in the “moderate” and “strong” categories perceived their risk as at above or much above the average risk
Thompson et al., 2010 United Kingdom Cross-sectional, descriptive study	103 family members of patient’s with premature CHD 57% females Median age of 41 Race/ethnicity not provided Participants from The Scottish Health Survey were used as the general population control group	To compare the cardiovascular risk factors of family members of individuals with premature CHD to a general population control group Structured, nurse-administered questionnaires to collect data on demographic information, lifestyle cardiovascular risk factors and medical history; anthropometric measurements, resting BP, and fasting blood sample obtained	Five family members (5%) had prevalent CHD A significantly higher percentage had an ASSIGN risk score >20% compared with the general population (13% vs. 2%; p<0.001) 37% of family members were aware they were at increased risk and only 50% had had their BP and serum cholesterol level checked in the previous three years Awareness of increased risk was higher among offspring (48%) than siblings (34%)
Darlow et al., 2012 United States Cross-sectional, descriptive study	397 overweight or obese women based on self-reported weight and height Ages ranged from 18 to 80 (mean, 38.0; SD ± 13.4) 42.8% African American, 29.7% Hispanic, 27.5% Caucasian	To investigate associations between weight perceptions and perceived risk for HD among overweight or obese women Study measures: demographic information, self-perceived weight status, degree to which weight was a health problem, perceived risk based on persons the same age and sex, health literacy	Perceiving oneself as overweight (OR, 4.33; 95% CI, 1.26–14.86) and FH of HD (OR=2.25; 95% CI: 1.08–4.69) were associated with greater perceived risk for HD For respondents with a lower health literacy, perceiving oneself as overweight was associated with greater perceived risk for HD (OR=4.69; 95% CI: 1.02–21.62)
Diaz et al., 2012 United States Cross-sectional, descriptive study	183 Hispanic adults 51% female Mean age of 36 for females; mean age of 38 for males	To examine and compare perceived versus actual risk for developing CVD in a Hispanic sample Study measures: demographic information, health status, health behaviors, Tool to Assess Likelihood of Fasting Glucose Impairment, Personal Heart Early Assessment Risk Tool, and perceived risk status	14.8% of respondents underestimated their 10-year CHD risk Respondents with diagnosed hypertension (38.8% vs. 5.5; p<.001), high cholesterol (38.5% vs. 5.5%; p<.001) or a FH of heart attack (30% vs. 11.6%; p=.02) were more likely to underestimate their 10-year CHD risk Men were more likely to underestimate their risk for and CHD risk compared to women (26.1% men vs. 3.4% women; p<.001)

Abbreviations: BP, blood pressure; BMI, body mass index; CAC, coronary artery calcification; CHD, coronary heart disease; CVD, cardiovascular disease; CI, confidence interval; FH, family history; FDR, first-degree-relative; HD, heart disease; HPB, health-promoting behavior; HPLP II, Health-Promoting Lifestyle Profile II; HDL, high-density lipoprotein; LDL, low-density lipoprotein; MI, myocardial infarction; OR, odds ratio; RCT, randomized control trial; SD, standard deviation