Self-rated cardiovascular risk and 15-year cardiovascular mortality

UMMS Affiliation

Department of Quantitative Health Sciences

Publication Date


Document Type



Adult; Aged; Cardiovascular Diseases; Female; *Health Knowledge, Attitudes, Practice; Humans; Male; Middle Aged; New England; Population Surveillance; Risk Assessment; Risk Reduction Behavior; *Self Assessment (Psychology); Sex Factors; Survival Analysis


Bioinformatics | Biostatistics | Epidemiology | Health Services Research


PURPOSE: Many individuals perceive their cardiovascular disease (CVD) risk to be lower than established clinical tools would estimate, yet little is known about the long-term consequences of holding such optimistic beliefs. We evaluated whether lower self-ratings of CVD risk are associated with lower rates of CVD death after addressing potential confounding by an extensive set of social and biologic CVD risk factors.

METHODS: We conducted a 15-year mortality surveillance study of adults aged 35 to 75 years from southeastern New England (n = 2,816) who had no history of myocardial infarction. Baseline evaluation in 1990-1992 included household interview, anthropomorphic measures, and laboratory analyses. Outcomes were obtained using the National Death Index records through December 2005.

RESULTS: Rating oneself to be at lower-than-average risk for one's age and sex was associated with lower rates of CVD mortality among men (hazard ratio [HR]=0.3; 95% confidence interval [CI], 0.2-0.7) but not among women (HR = 0.9; 95% CI, 0.5-1.7). None of the following weakened the findings among men: adjustment for baseline Framingham Risk Score, propensity score adjustment for both social and biologic factors, and censoring the first 2 years of surveillance.

CONCLUSIONS: Lower self-ratings of CVD risk are independently associated with lower rates of CVD death among men.

DOI of Published Version



Ann Fam Med. 2008 Jul-Aug;6(4):302-6. Link to article on publisher's site

Journal/Book/Conference Title

Annals of family medicine

PubMed ID


Related Resources

Link to Article in PubMed