Self-perceived physical health predicts cardiovascular disease incidence and death among postmenopausal women

BMC Public Health

Marcia L Stefanick⁷  Jennifer Robinson⁸  Lisa W Martin⁵  Norrina Allen³  Martha L Daviglus³  Manisha Desai⁴  Candyce Kroenke²  Hilary Tindle¹  Jessica Kubo⁴  Robert Brunner⁶  Nazmus Saquib⁷ 

[1] School of Medicine and Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA;Oakland Kaiser Permanente, Oakland, CA, USA;Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA;Quantitative Sciences Unit, General Medical Disciplines, Department of Medicine, Stanford University, Stanford, CA, USA;George Washington University, Washington DC, USA;University of Nevada, Reno, NE, USA;Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA;University of Iowa, Iowa City, IA, USA

关键词: All-cause death;    Cardiovascular disease;    Mental component summary;    Physical component summary;   

Others  :  1162213
DOI  :  10.1186/1471-2458-13-468

 received in 2012-11-12, accepted in 2013-04-29,  发布年份 2013

【 摘 要 】

Background

Physical and Mental Component Summary (PCS, MCS, respectively) scales of SF- 36 health-related-quality-of-life have been associated with all-cause and cardiovascular disease (CVD) mortality. Their relationships with CVD incidence are unclear. This study purpose was to test whether PCS and/or MCS were associated with CVD incidence and death.

Methods

Postmenopausal women (aged 50–79 years) in control groups of the Women’s Health Initiative clinical trials (n = 20,308) completed the SF-36 and standardized questionnaires at trial entry. Health outcomes, assessed semi-annually, were verified with medical records. Cox regressions assessed time to selected outcomes during the trial phase (1993–2005).

Results

A total of 1075 incident CVD events, 204 CVD-specific deaths, and 1043 total deaths occurred during the trial phase. Women with low versus high baseline PCS scores had less favorable health profiles at baseline. In multivariable models adjusting for baseline confounders, participants in the lowest PCS quintile (reference = highest quintile) exhibited 1.8 (95%CI: 1.4, 2.3), 4.7 (95%CI: 2.3, 9.4), and 2.1 (95%CI: 1.7, 2.7) times greater risk of CVD incidence, CVD-specific death, and total mortality, respectively, by trial end; whereas, MCS was not significantly associated with CVD incidence or death.

Conclusion

Physical health, assessed by self-report of physical functioning, is a strong predictor of CVD incidence and death in postmenopausal women; similar self-assessment of mental health is not. PCS should be evaluated as a screening tool to identify older women at high risk for CVD development and death.

【 授权许可】

   
2013 Saquib et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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