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.