Abstract
Background Previous studies have reported an increased risk of death in those who report their is poor, however the role of underlying and subclinical disease in this association has not been carefully studied. Methods The assoclations between perceived health status and mortality from all causes and cardiovascular disease, incidence of myocardial infarction, carotid atherosclerosis, forced expiratory volume, and maximal exercise capacity were studied in the kuopio Ischaemic Heart Disease Risk Factor Study, a population-based of 2682 men, aged 42–60, in eastern Finland. Results There were strong, statistically significant, age-adjusted associations between level of perceived health and mortality from all causes (RHbad versus good= 3.67), cardiovascular causes (RHbad verses good = 6.64), and Incidence of myocardial inferction (RHbad verses good = 3.67). Perceived health levels were strongly associated with risk factors and diseases Indicators The associations with mortality and myocardial infarctlon outcomes were considerably weakened with prograssive adjustment for eight risk factors and prevalent disease. Higher levels of percaived health were associated with less carotid atheroscierosis, and greater forced explatory volume and maximal exercise capacity. Associations between level of perceived health and these Indicators were considerably stronger in those with prevalent diseases than in those who were healthy. Conclusions The overall pattern of results suggests that perceived health levels mainly reflect underlying disease burden.