RT Journal Article
SR Electronic
T1 Self-Rated Cardiovascular Risk and 15-Year Cardiovascular Mortality
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 302
OP 306
DO 10.1370/afm.859
VO 6
IS 4
A1 Robert Gramling
A1 William Klein
A1 Mary Roberts
A1 Molly E. Waring
A1 David Gramling
A1 Charles B. Eaton
YR 2008
UL http://www.annfammed.org/content/6/4/302.abstract
AB 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.