Self-Rated Health Status and Risk of Ischemic Heart Disease in the China Kadoorie Biobank Study: A Population-Based Cohort Study

Background: self-rated health (srh) is a strong predictor of mortality in different populations. however,the associations between srh measures and risk of ischemic heart disease (ihd) have not been extensively explored,especially in a chinese population.methods and results: more than 500 000 adults from 10 cities in china were followed from baseline (2004-2008) through december 31,2013. global and age-comparative srh were reported from baseline questionnaires. incident ihd cases were identified through links to well-established disease registry systems and the national health insurance system. during 3 423 542 person-years of follow-up,we identified 24 705 incident cases of ihd. in multivariable-adjusted models,both global and age-comparative srh was significantly associated with incident ihd. compared with excellent srh,the hazard ratios for good,fair,and poor srh were 1.02 (95% confidence interval [ci],0.98-1.07),1.32 (95% ci,1.27-1.37),and 1.76 (95% ci,1.68-1.85),respectively. compared with better age-comparative srh,the hazard ratios for same and worse age-comparative srh were 1.23 (95% ci,1.19-1.27) and 1.78 (95% ci,1.70-1.86),respectively. the associations persisted in all subgroup analyses,although they were slightly modified by study location,education,and income levels.conclusions: a simple questionnaire for self-assessment of health status was significantly associated with incident ihd in chinese adults. individuals and healthcare providers can use srh measures as a convenient tool for assessing future ihd risk. © 2017 the authors. published on behalf of the american heart association,inc.,by wiley.