Gender differences in the association between self-rated health and hypertension in a Korean adult population

<p>Abstract</p> <p>Background</p> <p>Self-rated health (SRH) has been reported as a predictor of mortality in previous studies. This study aimed to examine whether SRH is independently associated with hypertension and if there is a gender difference in this association.</p> <p>Methods</p> <p>16,956 community dwelling adults aged 20 and over within a defined geographic area participated in this study. Data on SRH, socio-demographic factors (age, gender, marital status, education) and health behaviors (smoking status, alcohol consumption, physical activity) were collected. Body mass index and blood pressure were measured. Logistic regression models were used to determine a relationship between SRH and hypertension.</p> <p>Results</p> <p>32.5% of the participants were found to have hypertension. Women were more likely than men to rate their SRH as poor (<it>p </it>< 0.001), and the older age groups rated their SRH more negatively in both men and women (<it>p </it>< 0.001). While the multivariate-adjusted odds ratio (OR, 95% CI) of participants rating their SRH as very poor for hypertension in men was OR 1.70 (1.13-2.58), that in women was OR 2.83 (1.80-4.44). Interaction between SRH and gender was significant (<it>p </it>< 0.001).</p> <p>Conclusions</p> <p>SRH was independently associated with hypertension in a Korean adult population. This association was modified by gender.</p

Population-attributable risk of coronary heart disease risk factors during long-term follow-up: the Malmö Preventive Project.

Aims To calculate the population-attributable risk (PAR) of coronary events (CE) from 10 risk factors, during long-term follow-up. Methods We used both case-cohort and case-control analyses for calculation of PAR in relation to 10 baseline risk factors. First CE (fatal or nonfatal, n = 3072) in 22 444 males and 10 902 females was recorded during a mean follow-up of 20 years by use of national registers. Results Using a Cox regression analysis in a case-cohort design, smoking (prevalence in men 49%, women 37%) was the strongest risk factor, RR 2.29 (95% CI 2.09-2.52; PAR 39%), followed by hypercholesterolaemia, RR 1.70 (95% CI 1.56-1.86; PAR 18%), and diabetes, RR 1.67 (95% CI 1.41-1.99; PAR 3%). For women the strongest risk factors were smoking, RR 3.16 (95% CI 2.50-3.98; PAR 44%), diabetes, RR 2.59 (95% CI 1.78-3.76; PAR 6%), and hypertension, RR 2.47 (95% CI 1.94-3.14; PAR 23%). In men, smoking was the strongest predictor both after 10 years [RR 2.69 (95% CI 2.23-3.24)] and 20 years [RR 2.45 (95% CI 2.15-2.79)], followed by hypercholesterolaemia (RR 2.16-1.63), hypertension (RR 2.04-1.51), and diabetes (RR 1.85 -1.47). The case-control design gave very similar results. Total PAR varied from 74% (fully adjusted Cox regression, case-control, in men) to 116% in women (case-cohort). Conclusion Smoking is the most important long-term risk factor for CE in both genders, based on data from a population with a high proportion of smokers. Ten measured variables explained almost all variation in risk and could be used as a basis for intervention programmes