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Relationship of self-rated health with fatal and non-fatal outcomes in cardiovascular disease: a systematic review and meta-analysis.

Mavaddat N, Parker RA, Sanderson S, Mant J, Kinmonth AL - PLoS ONE (2014)

Bottom Line: People who rate their health as poor experience higher all-cause mortality.A comprehensive search of PubMed MEDLINE, EMBASE, CINAHL, BIOSIS, PsycINFO, DARE, Cochrane Library, and Web of Science was undertaken during June 2013.Those with current poor self-rated health may warrant additional input from health services to identify and address reasons for their low subjective health.

View Article: PubMed Central - PubMed

Affiliation: Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Strangeways Laboratory, Cambridge, United Kingdom.

ABSTRACT

Background: People who rate their health as poor experience higher all-cause mortality. Study of disease-specific association with self-rated health might increase understanding of why this association exists.

Objectives: To estimate the strength of association between self-rated health and fatal and non-fatal cardiovascular disease.

Methods: A comprehensive search of PubMed MEDLINE, EMBASE, CINAHL, BIOSIS, PsycINFO, DARE, Cochrane Library, and Web of Science was undertaken during June 2013. Two reviewers independently searched databases and selected studies. Inclusion criteria were prospective cohort studies or cohort analyses of randomised trials with baseline measurement of self-rated health with fatal or non-fatal cardiovascular outcomes. 20 studies were pooled quantitatively in different meta-analyses. Study quality was assessed using Newcastle-Ottawa scales.

Results: 'Poor' relative to 'excellent' self-rated health (defined by most extreme categories in each study, most often' poor' or 'very poor' and 'excellent' or 'good') was associated over a follow-up of 2.3-23 years with cardiovascular mortality in studies: where varying degrees of adjustments had been made for cardiovascular disease risk (HR 1.79 (95% CI 1.50 to 2.14); 15 studies, I2 = 71.24%), and in studies reporting outcomes in people with pre-existing cardiovascular disease or ischaemic heart disease symptoms (HR 2.42 (95% CI 1.32 to 4.44); 3 studies; I2 = 71.83%). 'Poor' relative to 'excellent' self rated health was also associated with the combined outcome of fatal and non-fatal cardiovascular events (HR 1.90 (95% CI 1.26 to 2.87); 5 studies; I2 = 68.61%), Self-rated health was not significantly associated with non-fatal cardiovascular disease outcomes (HR 1.66 (95% CI 0.96 to 2.87); 5 studies; I2 = 83.60%).

Conclusions: Poor self rated health is associated with cardiovascular mortality in populations with and without prior cardiovascular disease. Those with current poor self-rated health may warrant additional input from health services to identify and address reasons for their low subjective health.

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Related in: MedlinePlus

Meta-analysis of fatal and non-fatal CVD events in unselected populations with varying degrees of control for CVD status and risk factors: Poor health relative to excellent health.
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pone-0103509-g005: Meta-analysis of fatal and non-fatal CVD events in unselected populations with varying degrees of control for CVD status and risk factors: Poor health relative to excellent health.

Mentions: Figure 5 shows the results of a meta-analysis of hazard ratios of poor health relative to excellent health for combined fatal and non-fatal CVD events from studies of unselected populations. The combined summary estimate for the hazard ratio was 1.90 (95% CI 1.26 to 2.87). The I2-statistic was 68.61%, falling to 0% without loss of significance after excluding van der Linde (2013) (see table 3). The Q-test for heterogeneity produced a test statistic of 12.74, which was significant (p = 0.013). There was no significant effect of number of years of follow-up on the summary estimate but the odds ratio for fatal and non-fatal CVD combined events was significantly higher for more recent publications (p = 0.012).


Relationship of self-rated health with fatal and non-fatal outcomes in cardiovascular disease: a systematic review and meta-analysis.

Mavaddat N, Parker RA, Sanderson S, Mant J, Kinmonth AL - PLoS ONE (2014)

Meta-analysis of fatal and non-fatal CVD events in unselected populations with varying degrees of control for CVD status and risk factors: Poor health relative to excellent health.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4116199&req=5

pone-0103509-g005: Meta-analysis of fatal and non-fatal CVD events in unselected populations with varying degrees of control for CVD status and risk factors: Poor health relative to excellent health.
Mentions: Figure 5 shows the results of a meta-analysis of hazard ratios of poor health relative to excellent health for combined fatal and non-fatal CVD events from studies of unselected populations. The combined summary estimate for the hazard ratio was 1.90 (95% CI 1.26 to 2.87). The I2-statistic was 68.61%, falling to 0% without loss of significance after excluding van der Linde (2013) (see table 3). The Q-test for heterogeneity produced a test statistic of 12.74, which was significant (p = 0.013). There was no significant effect of number of years of follow-up on the summary estimate but the odds ratio for fatal and non-fatal CVD combined events was significantly higher for more recent publications (p = 0.012).

Bottom Line: People who rate their health as poor experience higher all-cause mortality.A comprehensive search of PubMed MEDLINE, EMBASE, CINAHL, BIOSIS, PsycINFO, DARE, Cochrane Library, and Web of Science was undertaken during June 2013.Those with current poor self-rated health may warrant additional input from health services to identify and address reasons for their low subjective health.

View Article: PubMed Central - PubMed

Affiliation: Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Strangeways Laboratory, Cambridge, United Kingdom.

ABSTRACT

Background: People who rate their health as poor experience higher all-cause mortality. Study of disease-specific association with self-rated health might increase understanding of why this association exists.

Objectives: To estimate the strength of association between self-rated health and fatal and non-fatal cardiovascular disease.

Methods: A comprehensive search of PubMed MEDLINE, EMBASE, CINAHL, BIOSIS, PsycINFO, DARE, Cochrane Library, and Web of Science was undertaken during June 2013. Two reviewers independently searched databases and selected studies. Inclusion criteria were prospective cohort studies or cohort analyses of randomised trials with baseline measurement of self-rated health with fatal or non-fatal cardiovascular outcomes. 20 studies were pooled quantitatively in different meta-analyses. Study quality was assessed using Newcastle-Ottawa scales.

Results: 'Poor' relative to 'excellent' self-rated health (defined by most extreme categories in each study, most often' poor' or 'very poor' and 'excellent' or 'good') was associated over a follow-up of 2.3-23 years with cardiovascular mortality in studies: where varying degrees of adjustments had been made for cardiovascular disease risk (HR 1.79 (95% CI 1.50 to 2.14); 15 studies, I2 = 71.24%), and in studies reporting outcomes in people with pre-existing cardiovascular disease or ischaemic heart disease symptoms (HR 2.42 (95% CI 1.32 to 4.44); 3 studies; I2 = 71.83%). 'Poor' relative to 'excellent' self rated health was also associated with the combined outcome of fatal and non-fatal cardiovascular events (HR 1.90 (95% CI 1.26 to 2.87); 5 studies; I2 = 68.61%), Self-rated health was not significantly associated with non-fatal cardiovascular disease outcomes (HR 1.66 (95% CI 0.96 to 2.87); 5 studies; I2 = 83.60%).

Conclusions: Poor self rated health is associated with cardiovascular mortality in populations with and without prior cardiovascular disease. Those with current poor self-rated health may warrant additional input from health services to identify and address reasons for their low subjective health.

Show MeSH
Related in: MedlinePlus