Currently submitted to: JMIR Public Health and Surveillance
Date Submitted: Feb 1, 2026
Open Peer Review Period: Feb 2, 2026 - Mar 30, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Perceived versus objective cardiovascular disease risk and Adherence to Physical Activity in Diabetes :a multicenter cross-sectional study
ABSTRACT
Background:
CVDis a leading cause of mortality in diabetes. Discrepancies between perceived and objective CVD risk may influence PA, yet this relationship remains unclear in diabetes
Objective:
Explore the relationship between CVD risk perception and objective risk among diabetes, and determine whether CVD risk perception was associated with PA adherence.
Methods:
We evaluate perceived and objective CVD risk among 443 diabetes from the endocrinology and metabolism department of three tertiary grade-A hospital. Perceived risk was assessed using the Attitude and Beliefs about Cardiovascular Disease Risk Questionnaire,objective risk was calculated using the ChinaPAR,and PA adherence was self-reported using IPAQ-SF. The study analyzed the differences in risk perception among various demographic groups, explored the correlation between risk perception, objective risk, and PA adherence.
Results:
The CVD risk perception score among the diabetes was 53.49±10.54. Subgroup analysis indicated that various factors such as gender, age, living area, marital status, and household income were positively associated with CVD risk perception (P < 0.05). The objective risk (estimated 10-year CVD risk) was found to be 5.8% (2.3%, 8.2%). Spearman correlation analysis revealed a positive relationship between the risk perception and objective risk of diabetes (r = 0.152, P = 0.001). Among the participants, 39.1% demonstrated consistent disease risk perception with the objective CVD risk classification, while 24.2% underestimated their risk, and 163 36.8% overestimated their risk, with the difference being statistically significant (χ² = 5.824, P = 0.016).Higher adherence to PA was positively associated with both perceived risk ( r=0.097, p=0.041) and higher objective risk (r=0.109, p=0.022).
Conclusions:
Diabetes demonstrate a moderately high awareness of cardiovascular disease risk, yet a significant discrepancy exists between perceived and objective risk . Higher perceived risk is positively correlated with greater adherence to PA. Targeted risk communication and behavioral interventions are therefore crucial for improving patient health outcomes.
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