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

OBJECTIVES

To assess the importance of biomedical risk factors, social factors and self-reported health in the prediction of the first event of acute myocardial infarction (AMI) in an apparently healthy middle-aged population.

DESIGN

An incident case-control study.

SETTING

The study was nested within the Västerbotten Intervention Program and the Northern Sweden MONICA cohorts.

SUBJECTS

The study consists of 78 AMI 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 > or =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 modifies the impact of these risk factors.