SF-36 predicts 13-year CHD incidence in a middle-aged Swedish general population

Abstract

Purpose To study the predictive ability of each of the eight scales of SF-36 on 13-year all-cause mortality and incident coronary heart disease (CHD) in a general middle-aged population. Methods The population-based, longitudinal "Life-conditions, Stress and Health" study, in 2003-2004 enrolled 1007 persons aged 45-69 years (50% female), randomly sampled from the general population in Östergötland, Sweden. Variables at baseline included the SF-36 (health-related quality of life, HRQoL) and self-reported disease. Incident CHD (morbidity and mortality) and all-cause mortality data for the study population during the first 13 years from baseline were obtained from national Swedish registries. Results Seven of the eight SF-36 scales predicted CHD (sex-and age-adjusted Hazard Ratios up to 2.15; p ≤ 0.05), while only the Physical Functioning scale significantly predicted all-cause mortality. Further adjustments for presence of (selfreported) disease did not, in most cases, alter these significant predictions. Conclusion Low SF-36 scores predict risk of CHD, also after adjustment for present disease, supporting the biopsychosocial model of health and disease. Measures of HRQoL yield important information and can add to the cardiopreventive toolbox, including primary prevention efforts, as it is such a simple and relatively inexpensive tool.

Health-related quality of life and all-cause mortality among older healthy individuals in Australia and the United States: a prospective cohort study

“…Indeed, it has been shown that lower self-reported HRQoL is associated with higher morbidity and mortality in patients affected by chronic diseases such as cancer or heart failure [8,9]. Additionally, a systematic review of 47 studies concluded that higher HRQoL as measured by the physical component score was associated with lower all-cause mortality risk among the general population [10] which also aligns with the finding of a recent study in middle-aged Swedish adults [11].…”

Health-related quality of life and incident cardiovascular disease events in community-dwelling older people: A prospective cohort study

“…However, when PCS and MCS were treated as categorical variables in that study, lower MCS was only associated with CVD risk when PCS was also low [18]. Furthermore, a Swedish study with 1,001 people aged 45-69 years also showed that mental health and role limitations due to emotional problems subscales of the SF-36 were not associated with 13-year coronary heart disease (CHD) incidence [19]. In contrast, most of the sub-scales contributed heavier weights in the PCS calculation, such as bodily pain and role limitations due to physical problems predicted CHD (84% and 67% higher CHD risks for the group with the lowest compared to that with the highest scores) [19].…”

“…Lower HRQoL has been shown to predict a higher risk of hospital readmission and mortality in patients with CVD such as heart failure or ischemic heart disease [9,10], and CVD mortality among various community-dwelling samples, including in later life [11][12][13][14]. Some studies have also demonstrated that lower HRQoL is associated with higher CVD incidence among community-dwelling, predominantly middle-aged adults [15][16][17][18][19]. However, almost all previous studies focused on specific CVD subtypes [15][16][17]19] and most included samples of less than 10,000 individuals [15,17,19].…”

“…Some studies have also demonstrated that lower HRQoL is associated with higher CVD incidence among community-dwelling, predominantly middle-aged adults [15][16][17][18][19]. However, almost all previous studies focused on specific CVD subtypes [15][16][17]19] and most included samples of less than 10,000 individuals [15,17,19]. Given that older people are at a higher risk of CVD due to plaque build-up along the artery walls, changes in blood vessels, and increased risk of atrial fibrillation [20], it is of interest to investigate the association between HRQoL and the risk of incident CVD among older people in the community.…”

Multiple group membership, social network size, allostatic load and well-being: A mediation analysis

“…This is the focus of the present study. It is also worth noting that both physical and psychological well-being are associated cardiovascular disease morbidity and mortality [ 43 , 64 ] and all-cause mortality [ 40 ].…”