Distorted reflection symbolizing the disconnect between perceived and actual heart attack risk.

Are You Underestimating Your Heart Attack Risk? What Brazilian Men Can Teach Us

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Theo Raines in Health & Wellness November 2026 • 4 min read.

"Despite health campaigns, many men overestimate their cardiovascular health. Learn how to bridge the gap between perception and reality."


Cardiovascular disease (CVD) remains a leading cause of death worldwide, despite advancements in diagnosis and treatment. This persistent threat underscores the urgent need for effective prevention strategies. A critical component of these strategies is understanding how people perceive their own risk of developing CVD, particularly heart attacks.

Often, there's a significant gap between perceived risk and actual risk, calculated using tools like the Framingham Risk Score. This score considers factors like age, sex, smoking history, cholesterol levels, and blood pressure to estimate the 10-year probability of developing CVD. However, studies show that personal perception often doesn't align with these calculated risks, potentially hindering preventive action.

A recent study conducted in Boa Vista, Brazil, sheds light on this critical disconnect. The research, published in "Vascular Health and Risk Management," investigated the relationship between perceived lifetime risk of cardiovascular disease and calculated risk in a population of Masonic men. The findings reveal a concerning trend: many men underestimate their risk, even when traditional risk factors suggest otherwise.

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Tracking Cardiovascular Risk

The CDC's National Center for Health Statistics Data Query System provides estimates of angina, coronary heart disease, heart attacks, cholesterol, and blood pressure. These estimates draw on the National Health Interview Survey and the National Health and Nutrition Examination Survey. The American Heart Association's 2026 statistical report likewise covers cardiovascular risk factors including smoking, physical activity, nutrition, sleep, obesity, cholesterol, blood pressure, glucose control, and cardiovascular-kidney-metabolic syndrome.

The Brazilian Study: A Closer Look at Perceived vs. Actual Risk

Distorted reflection symbolizing the disconnect between perceived and actual heart attack risk.

The Brazilian study involved 101 Masonic men over the age of 40. Participants completed a health survey assessing their stress levels, overall health status, and perceived risk of experiencing a heart attack. Researchers also collected demographic and biological data to calculate each participant's Framingham Risk Score.

Here are some key points from the study's methodology:

  • Participants: Masonic men aged 40+ in Boa Vista, Brazil.
  • Data Collection: Health surveys, demographic information, physical examinations, and blood samples.
  • Risk Assessment: Framingham Risk Score calculated based on collected data.
  • Perceived Risk Assessment: Participants self-reported their perceived stress levels, overall health status, and likelihood of experiencing a heart attack.
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Research on Risk Perception

Recent research is examining how people perceive cardiovascular risk and whether they are prepared to use digital health tools. A 2026 study of rural hypertensive patients used questionnaires covering social support, cardiovascular disease risk perception, and digital health readiness. In southwest Nigeria, a mixed-method study reported that 28% of participants had poor CVD risk perception, with a mean score of 44.40±8.07.

Limits of Self-Assessment

A study of Brazilian male masons found that men who did not feel anxious were significantly more likely to perceive themselves as not being at risk of a heart attack, with P=0.029. This illustrates how emotional responses may shape perceived cardiovascular risk rather than reflect calculated risk alone. The study population was fairly small, so the authors' findings should be interpreted with caution, particularly for categories containing few men.

Comparing Risk Measures

Research on overweight and obesity has used population-specific datasets, including 7,229 adults from the 2002 China National Nutrition and Health Survey of Shanxi province and 4,140 children aged 7 to 12 years in Kaifu District, Changsha. These examples show that findings can depend on the population being studied and the method used to assess weight status, such as body mass index. Risk calculators also require similar caution: a comparison study reported that the accuracy of 10-year CVD calculators in Indians may not be the same as in other populations.

The study's findings revealed a significant disconnect between perceived and actual risk. While over half of the participants had a moderate to high risk of cardiovascular disease according to their Framingham Risk Score, less than a third perceived themselves to be at high risk. This highlights a potential blind spot in how individuals assess their own cardiovascular health.

Bridging the Gap: What Can You Do?

The Brazilian study underscores the importance of aligning perceived risk with actual risk. By understanding your individual risk factors and having open conversations with healthcare providers, you can take proactive steps to protect your heart health. Don't let a false sense of security put you at risk. Take charge of your cardiovascular well-being today.

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More Localized Cardiovascular Data

The CDC's Local Trends in Heart Disease and Stroke Mortality Dashboard is designed to support local maps using data on heart disease, stroke, risk factors, community characteristics, demographics, and proximity to care. The 2026 JACC Cardiovascular Statistics report identifies hypertension, diabetes, obesity, cholesterol, and cigarette smoking among the major cardiovascular risk factors in the United States. Together, these resources point toward cardiovascular planning that combines national statistics with local conditions and access to care.

Environmental and Social Drivers

A 2026 scoping review describes climate change as a threat to cardiovascular health and examines how health systems are responding to climate-related cardiovascular risks. Research on social factors and health policy links rapid urbanization with environmental and societal changes that affect daily habits and cardiovascular health. Another 2026 review identifies noise and light pollution, air pollution, contamination, chemical pollution, and climate change as environmental exposures that can contribute to CVD through oxidative stress, inflammation, autonomic imbalance, and endothelial dysfunction.

Turning Prevention into Access

A Frontiers review identifies policy instruments addressing behavioral and metabolic CVD risk factors, along with health-system interventions intended to improve cardiovascular outcomes. It also highlights financial, health workforce, health-system, and weak national-capacity challenges that can impede implementation. In underserved communities across New York City, the Heart-to-Heart Community Outreach Program screened uninsured adults for CVD risk factors, identified healthcare access barriers, and supported community engagement in translational research.

Perceived health and perceived risk moved together

Men reporting more stress, or rating their general health lower, were more likely to report high heart-attack risk. These links describe how participants’ own assessments aligned; they do not establish that stress or perceived health caused a change in cardiovascular risk.[1]

Stress and overall health perceptions were also related to each other: men who described higher stress tended to rate their general health lower. Taken together, the survey points to connected self-assessments, not a direct measure of how accurately each man judged his risk.[1]

What the study design leaves uncertain

  • The sample was small, and some categories included few men, so those category-level patterns warrant caution.[2]
  • The possible glucose relationship did not reach statistical significance; the authors suggested that few high-risk respondents may have limited the analysis.[1]
  • The authors could not tell whether participants viewed their diet as healthier than it was, or whether other influences explained their health status.[1]

How researchers studied Masonic men in Boa Vista

PopulationMasonic men aged >40 years in Boa Vista, Brazil[2]
SettingBoa Vista, Brazil[2]
Main outcomeAssociation between cardiovascular risk factors and perceived cardiovascular risk[2]
Effect sizeOver half had moderate or high CVD risk, while less than a third perceived themselves to be at high risk[2]
p-valueP=0.025 for association between overweight and perceived heart-attack risk[2]
Times cited10[2]

What remains unresolved about perception and risk

  • The study found an association between waist-to-hip ratio and cardiovascular risk, but not between that risk measure and height, weight, or body mass index. How these measures relate to perceived risk remains unsettled by these findings.[1]
  • Age and systolic pressure were associated with calculated cardiovascular risk, as expected because they contribute to the Framingham score; the findings do not show how much each factor shaped individual perceptions.[1]

Questions about the study's associations

Did overweight status correspond to perceived heart-attack risk?

Yes. Overweight masons were more likely to perceive themselves as being at risk of a heart attack; the reported association was statistically significant.[1]

Sources

  1. Association between perceived lifetime risk of cardiovascular disease and calculated risk in a male population in Brazil (Europe PMC, 2016)
  2. Association between perceived lifetime risk of cardiovascular disease and calculated risk in a male population in Brazil (Informa UK Limited, 2016)

About this Article -

Written with AI assistance from published research, and reviewed by the Mystum team. See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.2147/vhrm.s107874, Alternate LINK

Title: Association Between Perceived Lifetime Risk Of Cardiovascular Disease And Calculated Risk In A Male Population In Brazil

Subject: Pharmacology (medical)

Journal: Vascular Health and Risk Management

Publisher: Informa UK Limited

Authors: Mário Maciel De Lima Junior, Glaciane Rocha Da Silva, Sebastião Salazar Jansem Filho, Fabiana Granja

Published: 2016-06-01

Everything You Need To Know

1

What exactly is cardiovascular disease, and why should I be concerned about it?

Cardiovascular disease, or CVD, is a category of diseases affecting the heart and blood vessels. It's significant because it's a leading cause of death globally, indicating the urgent need for understanding personal risk factors and adopting preventative measures to reduce your chances of developing these conditions. The implications are substantial, affecting not only individual health but also public health resources and life expectancy.

2

What is the Framingham Risk Score, and why is it important to know my score?

The Framingham Risk Score is a tool used to estimate your 10-year probability of developing cardiovascular disease. It's important because it provides a calculated risk assessment based on factors such as age, sex, smoking history, cholesterol levels, and blood pressure, offering a more objective measure compared to personal perception. While the score uses these specific factors it is important to consider other risk factors such as family history, diet, exercise, and pre-existing conditions.

3

What did the study in Boa Vista, Brazil, find regarding heart attack risk?

The study in Boa Vista, Brazil, revealed that many Masonic men underestimated their risk of cardiovascular disease. This is significant because it highlights a dangerous disconnect between how people perceive their heart health and their actual risk based on factors assessed by the Framingham Risk Score. This disconnect can lead to a lack of preventive action, increasing the likelihood of heart-related issues.

4

What does it mean when there's a difference between perceived risk and actual risk?

The difference between perceived risk and actual risk refers to the gap between what you believe your risk of developing a condition like cardiovascular disease is, and what your actual risk is based on objective measures like the Framingham Risk Score. This is important because an inaccurate perception can lead to either complacency or unnecessary anxiety, both of which can negatively impact health behaviors and outcomes.

5

How can I bridge the gap between what I think my risk is and what my actual risk of heart attack might be?

To bridge the gap between perceived and actual risk, you should first understand your individual risk factors for cardiovascular disease by having open conversations with your healthcare provider. The implications of ignoring this gap are significant, as it could lead to delayed or inadequate preventive measures. Proactive engagement with healthcare professionals and tools like the Framingham Risk Score are essential for managing cardiovascular health effectively.

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