Key result
Higher health-related QoL is linked to stroke incidence but not IHD.
Why the study?
The impact of health-related quality of life on the occurrence of ischaemic heart disease and stroke was not well established in a general population cohort.
Does health-related quality of life impact the incidence of ischaemic heart disease and stroke in adults without prior cardiovascular events?
Cohort (n=3,283)
Does health-related quality of life impact the incidence of ischaemic heart disease and stroke in adults without prior cardiovascular events?
p-value: p=<0.050 for stroke; >0.050 for IHD
In an Iranian cohort, higher baseline health-related quality of life was paradoxically associated with an increased incidence of stroke, but not ischaemic heart disease.
Paradoxical QoL-stroke link should not change practice; leaves open confounding versus causality in primary prevention.
OBJECTIVE: The aim of study was to evaluate the impact of health-related quality of life (QoL) on the occurrence of ischaemic heart disease (IHD) and stroke using a validated questionnaire. METHODS: We followed the 3,283 subjects, aged ≥ 35 years and without history of cardiovascular events (CVE) over four years from 2007 to 2011 from the Isfahan cohort study. The World Health Organization QoL questionnaire (WHOQOL-BREF), which contains four separate domains, was used to assess QoL. Incidence rates of IHD and stroke were recorded during follow-up. Socioeconomic demographic data including marital state, educational level, occupation, income and place of living and metabolic risk factors such as diabetes mellitus (DM), hypertension (HTN), dyslipidaemia, body mass index and smoking were also recorded. RESULTS: More IHD (42%) and stroke (57%) patients were illiterate; while the educational status was significantly different only in the IHD group (P = 0.000). Differences in income and occupation were notable in patients with stroke and IHD, respectively, compared to subjects without them (P < 0.050). DM and HTN were significantly higher in IHD and stroke patients in comparison with subjects without CVE (P = 0.000). Two-way multivariate analyses of covariance test after age, educational status and metabolic risk factors adjustment showed that subjects with stroke had a significantly higher score in all QoL domains in comparison with individuals without stroke (P < 0.050). There was no significant association between QoL domains and IHD incidence (P > 0.050). CONCLUSION: This study indicates that there is no association between QoL and IHD incidence although there was a significant relationship between higher QoL and incidence of stroke.
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Dadjou et al. (2016) conducted a cohort in No history of cardiovascular events (n=3,283). Health-related quality of life (QoL) vs. Lower QoL was evaluated on Incidence of ischaemic heart disease (IHD) and stroke (p=<0.050 for stroke; >0.050 for IHD). Higher health-related quality of life was significantly associated with the incidence of stroke (P<0.050), but showed no significant association with the incidence of ischaemic heart disease.
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