The prevalence of cirrhosis is higher than previously estimated. Many cases may be undiagnosed, and more than half are potentially preventable by controlling diabetes, alcohol abuse, and viral hepatitis. Public health efforts are needed to reduce this disease burden, particularly among racial/ethnic minorities and individuals at lower socioeconomic status.

The authors examined the relation between self-reported health status and mortality among the following racial/ethnic groups: Native Americans, Asian/Pacific Islanders, blacks, whites, and Hispanics. They pooled 1986-1994 data from the National Health Interview Survey to obtain information on more than 700,000 cohort participants. Although fewer than 5,000 Native Americans are included in this cohort, the data provide information previously unavailable for this group. Also included are almost 17,000 Asian/Pacific Islanders, over 90,000 blacks, and over 50,000 Hispanics. The authors found strong associations between self-reported health status and both socioeconomic status and subsequent mortality. A self-report of fair or poor health was associated with at least a twofold increased risk of mortality for all racial/ethnic groups. Even after adjustment for socioeconomic status and measures of comorbidity, a significant relation was found between self-reported health status and subsequent mortality. The authors found that self-reported health status is a strong prognostic indicator for subsequent mortality for both genders and all racial/ethnic groups examined. These results emphasize the utility of using simple filter questions in population research.

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Echocardiographically determined left ventricular hypertrophy is an important prognostic marker in patients with or without coronary artery disease. The effect of reversing ventricular hypertrophy in patients with and without coronary disease deserves further study.