Baseline overall health-related quality of life predicts the 10-year incidence of cardiovascular events in a Chinese population

OBJECTIVE: To determine the relationship between baseline overall HRQOL as well as domain-specific HRQOL and incident cardiovascular (CV) events over 10 years of follow-up in a Chinese general population.

METHODS: We examined the above link using data from a prospective cohort study, conducted between 2002 and 2012 in 11 villages of Beijing. HRQOL was assessed using Chinese 35-item quality of life instrument, and CV risk factors were recorded in either 2002 or 2005. Subjects were followed through the end of the study period, or until they were censored due to an incident CV event [including myocardial infarction (MI) and stroke] or loss to follow-up.

RESULTS: A total of 1739 participants were eligible to be included in the current study [female 64.2 %, age 57.7 (8.4) years]. There were a total of 190 CV events during the follow-up (14,364 total person-years). Participants in the bottom 20 % had 85 % increase in risk of CV event [hazard ratio (HR) 1.85; 95 % CI 1.14-3.02] compared to those in top 20 % of overall HRQOL, after adjusting for sex, age, education, marital status, smoking, alcohol consumption, being physically active, hypertension, diabetes, high cholesterol, and obesity. Among the six HRQOL domains, the independence domain had the largest effect size (fully adjusted HR 2.91; 95 % CI 1.67-5.07), followed by physical domain (HR 1.66; 95 % CI 1.03-2.67). Other domains did not predict the incidence CV events in this cohort.

CONCLUSIONS: While overall lower HRQOL predicts subsequent risk of stroke and MI events, this appeared to be driven mainly by the independence domain.