Participant-Reported Health Status Predicts Cardiovascular and All-Cause Mortality Independent of Established and Nontraditional Biomarkers: Evidence From a Representative US Sample
Participant-Reported Health Status Predicts Cardiovascular and All-Cause Mortality Independent of Established and Nontraditional Biomarkers: Evidence From a Representative US Sample
复制标题
DOI：
10.1161/jaha.116.003741
复制
发表时间：
2016-09-01
影响因子：
5.4
通讯作者：
Muldoon, Matthew F.
中科院分区：
文献类型：
--
作者：
Barger, Steven D.;Cribbet, Matthew R.;Muldoon, Matthew F.
背景-参与者报告的健康状况是心血管健康的关键指标，但其相对于传统和非传统危险因素的预测价值尚不清楚。我们评估了参与者报告的健康状况(以自评健康为指标)预测心血管疾病和全因死亡风险是否超过10年的动脉粥样硬化性心血管疾病(ASCVD)风险得分和5个非传统风险生物标记物。方法和结果分析使用1999-2002年全国健康与营养检查调查中40至79岁人群(N=4677)的前瞻性观察数据。生命状况是在2011年确定的，在此期间有850人死亡，其中206人死于心血管疾病。我们在生存模型中根据自我评估健康的标准值回归了心血管疾病和全因死亡率，调整了年龄、性别、教育程度、现有慢性病、种族/民族、ASCVD风险和标准化生物标记物(纤维蛋白原、C反应蛋白、甘油三酯、白蛋白和尿酸)。在社会人口学调整的模型中，自评健康水平降低1-SD与心血管死亡风险增加相关(危险比[HR]，1.92；95%CI，1.51-2.45；P
Background-Participant-reported health status is a key indicator of cardiovascular health, but its predictive value relative to traditional and nontraditional risk factors is unknown. We evaluated whether participant-reported health status, as indexed by self-rated health, predicted cardiovascular disease, and all-cause mortality risk excess of 10-year atherosclerotic cardiovascular disease (ASCVD) risk scores and 5 nontraditional risk biomarkers.Methods and Results-Analyses used prospective observational data from the 1999-2002 National Health and Nutrition Examination Surveys among those aged 40 to 79 years (N= 4677). Vital status was ascertained through 2011, during which there were 850 deaths, 206 from cardiovascular disease (CVD). We regressed CVD and all-cause mortality on standardized values of self-rated health in survival models, adjusting for age, sex, education, existing chronic disease, race/ethnicity, ASCVD risk, and standardized biomarkers (fibrinogen, C-reactive protein [CRP], triglycerides, albumin, and uric acid). In sociodemographically adjusted models, a 1-SD decrease in self-rated health was associated with increased risk of CVD mortality (hazard ratio [HR], 1.92; 95% CI, 1.51-2.45; P