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

J Intern Med. 1998 Feb;243(2):99-107. doi: 10.1046/j.1365-2796.1998.00201.x.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Case-Control Studies
  • Female
  • Health Status*
  • Humans
  • Incidence
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Myocardial Infarction / epidemiology*
  • Myocardial Infarction / etiology
  • Myocardial Infarction / psychology*
  • Odds Ratio
  • Risk Factors
  • Socioeconomic Factors
  • Sweden / epidemiology