Self-rated cardiovascular risk and 15-year cardiovascular mortality

Robert Gramling, William Klein, Mary Roberts, Molly E. Waring, David Gramling, Charles B. Eaton

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


PURPOSE: Many individuals perceive their cardiovascular disease (CVD) risk to be lower than established clinical tools would estimate, yet little is known about the long-term consequences of holding such optimistic beliefs. We evaluated whether lower self-ratings of CVD risk are associated with lower rates of CVD death after addressing potential confounding by an extensive set of social and biologic CVD risk factors. METHODS: We conducted a 15-year mortality surveillance study of adults aged 35 to 75 years from southeastern New England (n = 2,816) who had no history of myocardial infarction. Baseline evaluation in 1990-1992 included household interview, anthropomorphic measures, and laboratory analyses. Outcomes were obtained using the National Death Index records through December 2005. RESULTS: Rating oneself to be at lower-than-average risk for one's age and sex was associated with lower rates of CVD mortality among men (hazard ratio [HR] = 0.3; 95% confidence interval [CI], 0.2-0.7) but not among women (HR = 0.9; 95% CI, 0.5-1.7). None of the following weakened the findings among men: adjustment for baseline Framingham Risk Score, propensity score adjustment for both social and biologic factors, and censoring the first 2 years of surveillance. CONCLUSIONS: Lower self-ratings of CVD risk are independently associated with lower rates of CVD death among men.

Original languageEnglish (US)
Pages (from-to)302-306
Number of pages5
JournalAnnals of family medicine
Issue number4
StatePublished - 2008


  • Cardiovascular diseases
  • Denial
  • Fear
  • Health knowledge, attitudes, practice
  • Risk reduction behavior
  • Social psychology

ASJC Scopus subject areas

  • Family Practice


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