PERCEIVED HEALTH MODIFIES THE EFFECT OF BIOMEDICAL RISK-FACTORS IN THE PREDICTION OF ACUTE MYOCARDIAL-INFARCTION - AN INCIDENT CASE-CONTROLSTUDY FROM NORTHERN SWEDEN

Objectives. To assess the importance of biomedical risk factors, socia l factors and self-reported health in the prediction of the first even t of acute myocardial infarction (AMI) in an apparently healthy middle -aged population. Design. An incident case-control study. Setting. The study was nested within the Vasterbotten Intervention Program and the Northern Sweden MONICA cohorts. Subjects. The study consists of 78 AM I cases with two randomly selected controls per case from the same stu dy cohorts. Results. Significant odds ratios were found for history of diabetes, daily smelting, cholesterol, body-mass index, hypertension, lower education and perceived ill health. In multivariate logistic re gression smoking, hypertension and cholesterol of greater than or equa l to 7.8 mmol L-1 remained significant. An interaction was observed be tween number of biomedical risk factors and perceived health. Conclusi ons. Smoking, hypertension and hypercholesterolaemia explain a major s hare of incident AMI events in a Swedish middle-aged population. The s tudy further illustrates that perceived ill health negatively modifies the impact of these risk factors.