Key result
Lowest baseline SF-36 scores predict ~115% greater 13-year incident CHD risk versus highest tertiles.
Why the study?
The predictive ability of each of the eight SF-36 scales on 13-year all-cause mortality and incident CHD in a general middle-aged population required study.
Does the SF-36 score predict 13-year all-cause mortality and incident coronary heart disease in a middle-aged general population?
Cohort (n=1,001)
Yes
Does the SF-36 score predict 13-year all-cause mortality and incident coronary heart disease in a middle-aged general population?
Low SF-36 scores independently predict the 13-year risk of incident coronary heart disease in a middle-aged general population, suggesting its utility as a simple cardiopreventive tool.
SF-36 subscales were associated with CHD incidence independent of self-reported disease; leaves open incremental value for risk prediction or prevention.
PURPOSE: To study the predictive ability of each of the eight scales of SF-36 on 13-year all-cause mortality and incident coronary heart disease (CHD) in a general middle-aged population. METHODS: The population-based, longitudinal "Life-conditions, Stress and Health" study, in 2003-2004 enrolled 1007 persons aged 45-69 years (50% female), randomly sampled from the general population in Östergötland, Sweden. Variables at baseline included the SF-36 (health-related quality of life, HRQoL) and self-reported disease. Incident CHD (morbidity and mortality) and all-cause mortality data for the study population during the first 13 years from baseline were obtained from national Swedish registries. RESULTS: Seven of the eight SF-36 scales predicted CHD (sex- and age-adjusted Hazard Ratios up to 2.15; p ≤ 0.05), while only the Physical Functioning scale significantly predicted all-cause mortality. Further adjustments for presence of (self-reported) disease did not, in most cases, alter these significant predictions. CONCLUSION: Low SF-36 scores predict risk of CHD, also after adjustment for present disease, supporting the biopsychosocial model of health and disease. Measures of HRQoL yield important information and can add to the cardiopreventive toolbox, including primary prevention efforts, as it is such a simple and relatively inexpensive tool.
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Nilsson et al. (2019) conducted a cohort in General middle-aged population (n=1,001). Low SF-36 scores (lowest tertile) vs. High SF-36 scores (highest tertile) was evaluated on 13-year incident coronary heart disease (first-time fatal or nonfatal myocardial infarction and/or symptomatic angina pectoris requiring invasive coronary revascularisation) (HR 2.15, 95% CI 1.26-3.66, p=0.005). Low baseline SF-36 scores significantly predicted the 13-year risk of incident coronary heart disease, with sex- and age-adjusted hazard ratios up to 2.15 for the lowest versus highest tertiles.
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