Self-rated health and cardiovascular disease incidence: results from a longitudinal population-based cohort in Norfolk, UK
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 characteri...
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| Veröffentlicht in: | PloS one 2013-06, Vol.8 (6), p.e65290-e65290 |
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| creator | van der Linde, Rianne M Mavaddat, Nahal Luben, Robert Brayne, Carol Simmons, Rebecca K Khaw, Kay Tee Kinmonth, Ann Louise |
| description | 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.
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.
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.
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 socio-demographic, 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. |
| doi_str_mv | 10.1371/journal.pone.0065290 |
| format | Article |
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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.
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.
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 socio-demographic, 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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0065290</identifier><identifier>PMID: 23755212</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adjustment ; Adult ; Age ; Aged ; Alcohol ; Alcohol use ; Biology ; Cancer ; Cardiovascular disease ; Cardiovascular diseases ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - mortality ; Cardiovascular Diseases - psychology ; Cholesterol ; Chronic illnesses ; Demographics ; Development and progression ; Diabetes ; Diagnosis ; Diagnostic Self Evaluation ; Family medical history ; Female ; Hazards ; Health care ; Health risk assessment ; Health risks ; Health screening ; Health services ; Health Status ; Heart ; Humans ; Incidence ; Longitudinal Studies ; Male ; Medicine ; Mens health ; Methods ; Middle Aged ; Morbidity ; Mortality ; Nutrition research ; Population ; Population studies ; Primary care ; Proportional Hazards Models ; Prospective Studies ; Public health ; Risk analysis ; Risk Factors ; Smoking ; Social Class ; Social classes ; Sociodemographics ; Statistical models ; Studies ; Survival Analysis ; United Kingdom - epidemiology ; Womens health</subject><ispartof>PloS one, 2013-06, Vol.8 (6), p.e65290-e65290</ispartof><rights>COPYRIGHT 2013 Public Library of Science</rights><rights>2013 van der Linde et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2013 van der Linde et al 2013 van der Linde et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c758t-5dcae0e86df706c9b4bd2d97f942286381d28bf3159c5576d5f04c03b2d6dcc73</citedby><cites>FETCH-LOGICAL-c758t-5dcae0e86df706c9b4bd2d97f942286381d28bf3159c5576d5f04c03b2d6dcc73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3670935/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3670935/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27321,27901,27902,33751,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23755212$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>van der Linde, Rianne M</creatorcontrib><creatorcontrib>Mavaddat, Nahal</creatorcontrib><creatorcontrib>Luben, Robert</creatorcontrib><creatorcontrib>Brayne, Carol</creatorcontrib><creatorcontrib>Simmons, Rebecca K</creatorcontrib><creatorcontrib>Khaw, Kay Tee</creatorcontrib><creatorcontrib>Kinmonth, Ann Louise</creatorcontrib><title>Self-rated health and cardiovascular disease incidence: results from a longitudinal population-based cohort in Norfolk, UK</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>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.
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.
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.
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 socio-demographic, 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.</description><subject>Adjustment</subject><subject>Adult</subject><subject>Age</subject><subject>Aged</subject><subject>Alcohol</subject><subject>Alcohol use</subject><subject>Biology</subject><subject>Cancer</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Cardiovascular Diseases - epidemiology</subject><subject>Cardiovascular Diseases - mortality</subject><subject>Cardiovascular Diseases - psychology</subject><subject>Cholesterol</subject><subject>Chronic illnesses</subject><subject>Demographics</subject><subject>Development and progression</subject><subject>Diabetes</subject><subject>Diagnosis</subject><subject>Diagnostic Self Evaluation</subject><subject>Family medical history</subject><subject>Female</subject><subject>Hazards</subject><subject>Health care</subject><subject>Health risk assessment</subject><subject>Health risks</subject><subject>Health screening</subject><subject>Health services</subject><subject>Health Status</subject><subject>Heart</subject><subject>Humans</subject><subject>Incidence</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Medicine</subject><subject>Mens health</subject><subject>Methods</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Nutrition research</subject><subject>Population</subject><subject>Population studies</subject><subject>Primary care</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Public health</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Smoking</subject><subject>Social Class</subject><subject>Social classes</subject><subject>Sociodemographics</subject><subject>Statistical models</subject><subject>Studies</subject><subject>Survival Analysis</subject><subject>United Kingdom - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>van der Linde, Rianne M</au><au>Mavaddat, Nahal</au><au>Luben, Robert</au><au>Brayne, Carol</au><au>Simmons, Rebecca K</au><au>Khaw, Kay Tee</au><au>Kinmonth, Ann Louise</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Self-rated health and cardiovascular disease incidence: results from a longitudinal population-based cohort in Norfolk, UK</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2013-06-03</date><risdate>2013</risdate><volume>8</volume><issue>6</issue><spage>e65290</spage><epage>e65290</epage><pages>e65290-e65290</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>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.
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.
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.
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 socio-demographic, 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.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>23755212</pmid><doi>10.1371/journal.pone.0065290</doi><tpages>e65290</tpages><oa>free_for_read</oa></addata></record> |
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| recordid | cdi_plos_journals_1363189623 |
| source | PLoS; MEDLINE; PubMed Central; Directory of Open Access Journals; Free Full-Text Journals in Chemistry; Sociological Abstracts; EZB Electronic Journals Library |
| subjects | Adjustment Adult Age Aged Alcohol Alcohol use Biology Cancer Cardiovascular disease Cardiovascular diseases Cardiovascular Diseases - epidemiology Cardiovascular Diseases - mortality Cardiovascular Diseases - psychology Cholesterol Chronic illnesses Demographics Development and progression Diabetes Diagnosis Diagnostic Self Evaluation Family medical history Female Hazards Health care Health risk assessment Health risks Health screening Health services Health Status Heart Humans Incidence Longitudinal Studies Male Medicine Mens health Methods Middle Aged Morbidity Mortality Nutrition research Population Population studies Primary care Proportional Hazards Models Prospective Studies Public health Risk analysis Risk Factors Smoking Social Class Social classes Sociodemographics Statistical models Studies Survival Analysis United Kingdom - epidemiology Womens health |
| title | Self-rated health and cardiovascular disease incidence: results from a longitudinal population-based cohort in Norfolk, UK |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-11T20%3A42%3A34IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Self-rated%20health%20and%20cardiovascular%20disease%20incidence:%20results%20from%20a%20longitudinal%20population-based%20cohort%20in%20Norfolk,%20UK&rft.jtitle=PloS%20one&rft.au=van%20der%20Linde,%20Rianne%20M&rft.date=2013-06-03&rft.volume=8&rft.issue=6&rft.spage=e65290&rft.epage=e65290&rft.pages=e65290-e65290&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0065290&rft_dat=%3Cgale_plos_%3EA478436292%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1363189623&rft_id=info:pmid/23755212&rft_galeid=A478436292&rft_doaj_id=oai_doaj_org_article_cd5a1335368b4572bd69ed0fea35d700&rfr_iscdi=true |