Self‐Rated Health Status and Risk of Ischemic Heart Disease in the China Kadoorie Biobank Study: A Population‐Based Cohort Study
Authors: Dong Wenhong , Pan Xiong‐Fei , Yu Canqing , Lv Jun , Guo Yu , Bian Zheng , Yang Ling , Chen Yiping , Wu Tangchun , Chen Zhengming , Pan An , Li Liming , Chen Junshi , Chen Zhengming , Collins Rory , Peto Richard , Avery Daniel , Boxall Ruth , Derrick Bennett , Chang Yumei , Clarke Robert , Du Huaidong , Gilbert Simon , Hacker Alex , Hill Mike , Holmes Michael , Iona Andri , Kartsonaki Christiana , Kerosi Rene , Kong Ling , Kurmi Om , Lancaster Garry , Lewington Sarah , Lin Kuang , McDonnell John , Millwood Iona , Nie Qunhua , Radhakrishnan Jayakrishnan , Rafiq Sajjad , Ryder Paul , Sansome Sam , Schmidt Dan , Sherliker Paul , Sohoni Rajani , Stevens Becky , Turnbull Iain , Walters Robin , Wang Jenny , Wang Lin , Wright Neil , Yang Ling , Yang Xiaoming , Bian Zheng , Guo Yu , Han Xiao , Hou Can , Lv Jun , Pei Pei , Tan Yunlong , Yu Canqing , Pang Zengchang , Gao Ruqin , Li Shanpeng , Wang Shaojie , Liu Yongmei , Du Ranran , Zang Yajing , Cheng Liang , Tian Xiaocao , Zhang Hua , Zhai Yaoming , Ning Feng , Sun Xiaohui , Li Feifei , Lv Silu , Wang Junzheng , Hou Wei , Zeng Mingyuan , Jiang Ge , Zhou Xue , Yang Liqiu , He Hui , Yu Bo , Li Yanjie , Xu Qinai , Kang Quan , Guo Ziyan , Wang Dan , Hu Ximin , Wang Hongmei , Chen Jinyan , Fu Yan , Fu Zhenwang , Wang Xiaohuan , Weng Min , Guo Zhendong , Wu Shukuan , Li Yilei , Li Huimei , Fu Zhifang , Wu Ming , Zhou Yonglin , Zhou Jinyi , Tao Ran , Yang Jie , Su Jian , liu Fang , Zhang Jun , Hu Yihe , Lu Yan , Ma Liangcai , Tang Aiyu , Zhang Shuo , Jin Jianrong , Liu Jingchao , Tang Zhenzhu , Chen Naying , Huang Ying , Li Mingqiang , Meng Jinhuai , Pan Rong , Jiang Qilian , Lan Jian , Liu Yun , Wei Liuping , Zhou Liyuan , Chen Ningyu , Wang Ping , Meng Fanwen , Qin Yulu , Wang Sisi , Wu Xianping , Zhang Ningmei , Chen Xiaofang , Zhou Weiwei , Luo Guojin , Li Jianguo , Chen Xiaofang , Zhong Xunfu , Liu Jiaqiu , Sun Qiang , Ge Pengfei , Ren Xiaolan , Dong Caixia , Zhang Hui , Mao Enke , Wang Xiaoping , Wang Tao , zhang Xi , Zhang Ding , Zhou Gang , Feng Shixian , Chang Liang , Fan Lei , Gao Yulian , He Tianyou , Sun Huarong , He Pan , Hu Chen , Zhang Xukui , Wu Huifang , He Pan , Yu Min , Hu Ruying , Wang Hao , Qian Yijian , Wang Chunmei , Xie Kaixu , Chen Lingli , Zhang Yidan , Pan Dongxia , Gu Qijun , Huang Yuelong , Chen Biyun , Yin Li , Liu Huilin , Fu Zhongxi , Xu Qiaohua , Xu Xin , Zhang Hao , Long Huajun , Li Xianzhi , Zhang Libo , Qiu Zhe 
Published: September 2017

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.