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Ann Fam Med. 2008 Jul-Aug;6(4):302-6. doi: 10.1370/afm.859.

Self-rated cardiovascular risk and 15-year cardiovascular mortality.

Author information

1
Center for Primary Care and Prevention, Memorial Hospital of Rhode Island, Pawtucket, Rhode Island, USA. Robert_Gramling@URMC.Rochester.edu

Abstract

PURPOSE:

Many individuals perceive their cardiovascular disease (CVD) risk to be lower than established clinical tools would estimate, yet little is known about the long-term consequences of holding such optimistic beliefs. We evaluated whether lower self-ratings of CVD risk are associated with lower rates of CVD death after addressing potential confounding by an extensive set of social and biologic CVD risk factors.

METHODS:

We conducted a 15-year mortality surveillance study of adults aged 35 to 75 years from southeastern New England (n = 2,816) who had no history of myocardial infarction. Baseline evaluation in 1990-1992 included household interview, anthropomorphic measures, and laboratory analyses. Outcomes were obtained using the National Death Index records through December 2005.

RESULTS:

Rating oneself to be at lower-than-average risk for one's age and sex was associated with lower rates of CVD mortality among men (hazard ratio [HR]=0.3; 95% confidence interval [CI], 0.2-0.7) but not among women (HR = 0.9; 95% CI, 0.5-1.7). None of the following weakened the findings among men: adjustment for baseline Framingham Risk Score, propensity score adjustment for both social and biologic factors, and censoring the first 2 years of surveillance.

CONCLUSIONS:

Lower self-ratings of CVD risk are independently associated with lower rates of CVD death among men.

PMID:
18626029
PMCID:
PMC2478507
DOI:
10.1370/afm.859
[Indexed for MEDLINE]
Free PMC Article
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