Perceived health modifies the effect of biomedical risk factors in the prediction of acute myocardial infarction. An incident case-control study from Northern Sweden

Abstract

Objectives. To assess the importance of biomedical risk factors, social factors anti self-reported health in the prediction of the first event of acute myocardial infarction (AM1) in an apparently healthy middleaged population. Design. An incident case-control study. Setting. The study was nested within the Vasterbotten Intervention Program anti the Northern Sweden MONICA cohorts. Subjects. The study consists of 78 AM1 cases with two randomly selected controls per case from the same study cohorts. Results. Significant odds ratios were found for history of diabetes, daily smoking, cholesterol, body-mass index, hypertension, lower education and perceived ill health. In multivariate logistic regression smoking, hypertension and cholesterol of ≤7.8 mmol L-1 remained significant. An interaction was observed between number of biomedical risk factors and perceived health. Conclusions. Smoking, hypertension and hypercholesterolaemia explain a major share of incident AMI events in a Swedish middle-aged population. The study further illustrates that perceived ill health negatively modities the impact of these risk factors.