title: Self-rated cardiovascular risk and 15-year cardiovascular mortality.
abstract: OBJECTIVE
  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.
authors.affiliation: Center for Primary Care and Prevention, Memorial Hospital of Rhode Island, Pawtucket, Rhode Island, USA. Robert_Gramling@URMC.Rochester.edu
authors.forename: Robert
authors.initials: R
authors.lastname: Gramling
authors.forename: William
authors.initials: W
authors.lastname: Klein
authors.forename: Mary
authors.initials: M
authors.lastname: Roberts
authors.forename: Molly E
authors.initials: ME
authors.lastname: Waring
authors.forename: David
authors.initials: D
authors.lastname: Gramling
authors.forename: Charles B
authors.initials: CB
authors.lastname: Eaton
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality* / Q000517:prevention & control / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009511:New England / Q000453:epidemiology; D011159:Population Surveillance; D018570:Risk Assessment; D040242:Risk Reduction Behavior; D012647:Self-Assessment; D012737:Sex Factors; D016019:Survival Analysis