Key result
Higher self-rated health links to ~13% lower hypertension odds per 10-point increase.
Why the study?
Prior studies suggest self-rated health may indicate cardiovascular disease, but its relationship with cardiovascular risk factors and subclinical cardiac disease needed evaluation in the Amazon Basin.
Is self-rated health associated with cardiovascular risk factors and subclinical cardiac disease in a low-income setting?
Cross-Sectional (n=574)
Is self-rated health associated with cardiovascular risk factors and subclinical cardiac disease in a low-income setting?
Effect estimate: OR 0.87 (95% CI 0.78 to 0.97)
p-value: p=0.01
In a low-income Brazilian population, higher self-rated health is associated with better cardiovascular risk profiles (lower odds of hypertension and hypercholesterolemia) but does not correlate with echocardiographic evidence of subclinical cardiac disease.
May signal risk factor burden in low-income settings; hypothesis-generating for subclinical disease, needs prospective validation.
OBJECTIVE: Prior studies have suggested that self-rated health may be a useful indicator of cardiovascular disease. Consequently, we aimed to assess the relationship between self-rated health, cardiovascular risk factors and subclinical cardiac disease in the Amazon Basin. DESIGN: Cross-sectional study. SETTING, PARTICIPANTS AND INTERVENTIONS: In participants from the Amazon Basin of Brazil we obtained self-rated health according to a Visual Analogue Scale, ranging from 0 (poor) to 100 (excellent). We performed questionnaires, physical examination and echocardiography. Logistic and linear regression models were applied to assess self-rated health, cardiac risk factors and cardiac disease by echocardiography. Multivariable models were mutually adjusted for other cardiovascular risk factors, clinical and socioeconomic data, and known cardiac disease. OUTCOME MEASURES: Cardiovascular risk factors and subclincial cardiac disease by echocardiography. RESULTS: A total of 574 participants (mean age 41 years, 61% female) provided information on self-rated health (mean 75±21 (IQR 60-90) points). Self-rated health (per 10-point increase) was negatively associated with hypertension (OR 0.87 (95% CI 0.78 to 0.97), p=0.01), hypercholesterolaemia (OR 0.89 (95%CI 0.80 to 0.99), p=0.04) and positively with healthy diet (OR 1.13 (95%CI 1.04 to 1.24), p=0.004). Sex modified these associations (p-interaction <0.05) such that higher self-rated health was associated with healthy diet and physical activity in men, and lower odds of hypertension and hypercholesterolaemia in women. No relationship was found with left ventricular ejection fraction <45% (OR 0.97 (95% CI 0.77 to 1.23), p=0.8), left ventricular hypertrophy (OR 0.97 (95% CI 0.76 to 1.24), p=0.81) or diastolic dysfunction (OR 1.09 (95% CI 0.85 to 1.40), p=0.51). CONCLUSION: Self-rated health was positively associated with health parameters in the Amazon Basin, but not with subclinical cardiac disease by echocardiography. Our findings are of hypothesis generating nature and future studies should aim to determine whether assessment of self-rated health may be useful for screening related to policy-making or lifestyle interventions. TRIAL REGISTRATION NUMBER: Clinicaltrials.gov: NCT04445103; Post-results.
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Holm et al. (2022) conducted a cross-sectional in Cardiovascular risk factors and subclinical cardiac disease (n=574). Self-rated health was evaluated on Cardiovascular risk factors and subclincial cardiac disease by echocardiography (OR 0.87, 95% CI 0.78 to 0.97, p=0.01). Higher self-rated health (per 10-point increase) was associated with lower odds of hypertension (OR 0.87; 95% CI 0.78-0.97) and hypercholesterolemia, but not with subclinical cardiac disease.
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