Self-Rated Health and Cardiovascular Disease Incidence: Results from a Longitudinal Population-Based Cohort in Norfolk, UK
Self-Rated Health and Cardiovascular Disease Incidence: Results from a Longitudinal Population-Based Cohort in Norfolk, UK
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DOI：
10.1371/journal.pone.0065290
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发表时间：
2013-06-03
期刊：
影响因子：
3.7
通讯作者：
Kinmonth, Ann Louise
中科院分区：
文献类型：
--
作者：
van der Linde, Rianne M.;Mavaddat, Nahal;Kinmonth, Ann Louise
自评健康（SRH）可以预测包括心血管疾病（CVD）在内的慢性疾病的发病率。在以人群为基础的队列中，我们研究了SRH与CVD事件之间的关联，以及这种关联是否独立于社会人口统计学、临床和行为参与者特征。方法：基于人群的前瞻性队列研究（欧洲癌症-诺福克前瞻性调查）。20,941名年龄在39-74岁之间没有常见心血管疾病的男性和女性参加了基线健康检查（1993-1998），并随访了心血管疾病事件/死亡直到2007年3月（平均11岁）。在调整了社会人口、临床和行为风险因素后，我们使用Cox比例风险模型来量化基线SRH（以四分制报告-优秀、良好、一般、差）与随访时发生心血管疾病风险之间的关系。结果：基线SRH评分为优（17.8%），良（65.1%），一般（16.0%），差（1.2%）。在225,508人年的随访期间，不良SRH组发生55例（21.2%）心血管疾病事件，良好SRH组发生259例（7.0%）心血管疾病事件（HR 3.7, 95% CI 2.8-4.9）。调整行为危险因素（HR 2.6, 95% CI 1.9-3.5）和调整所有社会人口、临床和行为危险因素（HR 3.3, 95% CI 2.4-4.4）后，HR仍然显著。致命和非致命事件的相关性都很强，并且随着时间的推移仍然很强。结论：在健康的中年人群中，SRH是致命和非致命CVD事件的一个强有力的预测因子。一些关联可以用生活方式行为来解释，但在调整了社会人口、临床和行为风险因素并进行了十年的随访后，SRH仍然是一个强有力的预测因子。对于从事初级保健和公共卫生工作的人来说，这种易于获得的以病人为中心的健康状况衡量可能是个人和人口健康状况的有用指标。
Introduction: Self-rated health (SRH) predicts chronic disease morbidity including cardiovascular disease (CVD). In a population-based cohort, we examined the association between SRH and incident CVD and whether this association was independent of socio-demographic, clinical and behavioural participant characteristics.Methods: Population-based prospective cohort study (European Prospective Investigation of Cancer-Norfolk). 20,941 men and women aged 39-74 years without prevalent CVD attended a baseline health examination (1993-1998) and were followed for CVD events/death until March 2007 (mean 11 years). We used a Cox proportional hazards model to quantify the association between baseline SRH (reported on a four point scale - excellent, good, fair, poor) and risk of developing CVD at follow-up after adjusting for socio-demographic, clinical and behavioural risk factors.Results: Baseline SRH was reported as excellent by 17.8% participants, good by 65.1%, fair by 16.0% and poor by 1.2%. During 225,508 person-years of follow-up, there were 55 (21.2%) CVD events in the poor SRH group and 259 (7.0%) in the excellent SRH group (HR 3.7, 95% CI 2.8-4.9). The HR remained significant after adjustment for behavioural risk factors (HR 2.6, 95% CI 1.9-3.5) and after adjustment for all socio-demographic, clinical and behavioural risk factors (HR 3.3, 95% CI 2.4-4.4). Associations were strong for both fatal and non-fatal events and remained strong over time.Conclusions: SRH is a strong predictor of incident fatal and non-fatal CVD events in this healthy, middle-aged population. Some of the association is explained by lifestyle behaviours, but SRH remains a strong predictor after adjustment for sociodemographic, clinical and behavioural risk factors and after a decade of follow-up. This easily accessible patient-centred measure of health status may be a useful indicator of individual and population health for those working in primary care and public health.