Is self-rated health associated with ideal cardiovascular health? The Multi-Ethnic Study of Atherosclerosis

Background: Self-rated health (SRH) is an indicator of health status—a determinant of health-promoting behaviors and a predictor of morbidity/mortality. Little is known about the association between SRH and ideal cardiovascular health (CVH), as measured by the AHA Life's Simple 7 (LS7) metrics, or whether the relationship between SRH and CVH differs by race/ethnicity. Hypothesis: Favorable SRH is associated with better CVH. Methods: We conducted a cross-sectional analysis of 6457 men and women (4 race/ethnicities) who participated in the Multi-Ethnic Study of Atherosclerosis. SRH was measured on a 5-point Likert scale (excellent, very good, good, fair, and poor). CVH was assessed using the LS7 metrics, each scored from 0 to 2, with a total score of 0 to 14. Scores of 0 to 8 indicate inadequate, 9 to 10, average, and 11 to 14, optimal CVH. ORs and 95% CIs were calculated for associations between SRH and CVH scores using multinomial logistic regression, adjusted for age, sex, race/ethnicity, education, income, marital status, health insurance, and chronic diseases. Results: Mean age of participants was 62 ± 10 years; 53% were female. Odds of ideal CVH increased as SRH improved. Compared with poor–fair SRH, adjusted ORs and 95% CIs for optimal CVH by SRH status were excellent, 4.9 (3.4–7.0); very good, 2.2 (1.6–3.1); and good, 1.5 (1.1–2.1). Results were similar by race/ethnicity, sex, and age groups. Conclusions: More favorable SRH was associated with better CVH, irrespective of sex, race/ethnicity, or age. Further research could explore whether optimization of SRH predicts CVH.