Health beliefs and heart disease risk among middle-aged Swedish men. Results from screening in an urban primary care district

OBJECTIVE: To study the relationship between individual health beliefs and risk factors for coronary heart disease. DESIGN: Health beliefs indices, formed by factorial analysis of ratings of statements on health related matters in a questionnaire, were related to risk factors for coronary heart disease, assessed with physical examinations and self reports of medical history and habits. SETTING: An urban primary care district in Malmo, Sweden. SUBJECTS: A random sample of middle-aged men, invited to a health check-up. RESULTS: The participation rate was 453/705 (64%). "Perceived threat to health caused by illness" was positively related to previous information on high blood pressure, high plasma cholesterol, and/or diabetes (p = 0.01). In a model of logistic regression, adjusted for age, cohabitation, and previous medical history, health belief index on "threat to health" was related to low exercise habits (RR = 1.06, CI 1.01, 1.12). "Perceived control over illness" was related to high alcohol consumption (RR = 0.86, CI 0.75, 0.97), smoking (RR = 0.89, CI 0.79, 0.99), and high diastolic blood pressure (RR = 0.84, CI 0.75, 0.95). CONCLUSION: This cross-sectional study demonstrates relations between health beliefs, previous health-related experiences, and risk behaviour. To explore the causality of the former, longitudinal studies of changes in health beliefs after medical information are required