PERCEIVED HEALTH-STATUS AND MORBIDITY AND MORTALITY - EVIDENCE FROM THE KUOPIO ISCHEMIC-HEART-DISEASE RISK FACTOR STUDY

Background. Previous studies have reported an increased risk of death in those who report their health is poor, however the role of underlyi ng and subclinical disease in this association has not been carefully studied. Methods. The associations between perceived health status and mortality from all causes and cardiovascular disease, incidence of my ocardial infarction, carotid atherosclerosis, forced expiratory volume , and maximal exercise capacity were studied in the Kuopio Ischaemic H eart Disease Risk Factor Study, a population-based study of 2682 men, aged 42-60, in eastern Finland. Results. There were strong, statistica lly significant, age-adjusted associations between level of perceived health and mortality from all causes (RH(bad versus good) = 3.67), car diovascular causes (RH(bad versus good) = 6.64), and incidence of myoc ardial infarction (RH(bad versus good) = 3.87). Perceived health level s were strongly associated with risk factors and disease indicators. T he associations with mortality and myocardial infarction outcomes were considerably weakened with progressive adjustment for eight risk fact ors and prevalent disease. Higher levels of perceived health ware asso ciated with less carotid atherosclerosis, and greater forced expirator y volume and maximal exercise capacity. Associations between level of perceived health and these indicators were considerably stronger in th ose with prevalent diseases than in those who were healthy. Conclusion s. The overall pattern of results suggests that perceived health level s mainly reflect underlying disease burden.