PT  - JOURNAL ARTICLE
AU  - Robert Gramling
AU  - William Klein
AU  - Mary Roberts
AU  - Molly E. Waring
AU  - David Gramling
AU  - Charles B. Eaton
TI  - Self-Rated Cardiovascular Risk and 15-Year Cardiovascular Mortality
AID  - 10.1370/afm.859
DP  - 2008 Jul 01
TA  - The Annals of Family Medicine
PG  - 302--306
VI  - 6
IP  - 4
4099  - http://www.annfammed.org/content/6/4/302.short
4100  - http://www.annfammed.org/content/6/4/302.full
SO  - Ann Fam Med2008 Jul 01; 6
AB  - 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.