Self-Rated Health Status and Risk of Ischemic Heart Disease in the China Kadoorie Biobank Study: A Population-Based Cohort Study

J Am Heart Assoc. 2017 Sep 22;6(9):e006595. doi: 10.1161/JAHA.117.006595.

Abstract

Background: Self-rated health (SRH) is a strong predictor of mortality in different populations. However, the associations between SRH measures and risk of ischemic heart disease (IHD) have not been extensively explored, especially in a Chinese population.

Methods and results: More than 500 000 adults from 10 cities in China were followed from baseline (2004-2008) through December 31, 2013. Global and age-comparative SRH were reported from baseline questionnaires. Incident IHD cases were identified through links to well-established disease registry systems and the national health insurance system. During 3 423 542 person-years of follow-up, we identified 24 705 incident cases of IHD. In multivariable-adjusted models, both global and age-comparative SRH was significantly associated with incident IHD. Compared with excellent SRH, the hazard ratios for good, fair, and poor SRH were 1.02 (95% confidence interval [CI], 0.98-1.07), 1.32 (95% CI, 1.27-1.37), and 1.76 (95% CI, 1.68-1.85), respectively. Compared with better age-comparative SRH, the hazard ratios for same and worse age-comparative SRH were 1.23 (95% CI, 1.19-1.27) and 1.78 (95% CI, 1.70-1.86), respectively. The associations persisted in all subgroup analyses, although they were slightly modified by study location, education, and income levels.

Conclusions: A simple questionnaire for self-assessment of health status was significantly associated with incident IHD in Chinese adults. Individuals and healthcare providers can use SRH measures as a convenient tool for assessing future IHD risk.

Keywords: Chinese; cohort study; ischemic heart disease; self‐rated health status.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Biological Specimen Banks*
  • China / epidemiology
  • Female
  • Health Status*
  • Humans
  • Incidence
  • Life Style
  • Male
  • Middle Aged
  • Myocardial Ischemia / diagnosis*
  • Myocardial Ischemia / epidemiology
  • Population Surveillance
  • Predictive Value of Tests
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Self Report*
  • Socioeconomic Factors
  • Time Factors
  • Urban Health