title: Self-perceived physical health predicts cardiovascular disease incidence and death among postmenopausal women.
abstract: BACKGROUND
  Physical and Mental Component Summary (PCS, MCS, respectively) scales of SF- 36 health-related-quality-of-life have been associated with all-cause and cardiovascular disease (CVD) mortality. Their relationships with CVD incidence are unclear. This study purpose was to test whether PCS and/or MCS were associated with CVD incidence and death.
  
  
  METHODS
  Postmenopausal women (aged 50-79 years) in control groups of the Women's Health Initiative clinical trials (n = 20,308) completed the SF-36 and standardized questionnaires at trial entry. Health outcomes, assessed semi-annually, were verified with medical records. Cox regressions assessed time to selected outcomes during the trial phase (1993-2005).
  
  
  RESULTS
  A total of 1075 incident CVD events, 204 CVD-specific deaths, and 1043 total deaths occurred during the trial phase. Women with low versus high baseline PCS scores had less favorable health profiles at baseline. In multivariable models adjusting for baseline confounders, participants in the lowest PCS quintile (reference = highest quintile) exhibited 1.8 (95%CI: 1.4, 2.3), 4.7 (95%CI: 2.3, 9.4), and 2.1 (95%CI: 1.7, 2.7) times greater risk of CVD incidence, CVD-specific death, and total mortality, respectively, by trial end; whereas, MCS was not significantly associated with CVD incidence or death.
  
  
  CONCLUSIONS
  Physical health, assessed by self-report of physical functioning, is a strong predictor of CVD incidence and death in postmenopausal women; similar self-assessment of mental health is not. PCS should be evaluated as a screening tool to identify older women at high risk for CVD development and death.
authors.affiliation: Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA. nsaquib@stanford.edu.
authors.forename: Nazmus
authors.initials: N
authors.lastname: Saquib
authors.forename: Robert
authors.initials: R
authors.lastname: Brunner
authors.forename: Jessica
authors.initials: J
authors.lastname: Kubo
authors.forename: Hilary
authors.initials: H
authors.lastname: Tindle
authors.forename: Candyce
authors.initials: C
authors.lastname: Kroenke
authors.forename: Manisha
authors.initials: M
authors.lastname: Desai
authors.forename: Martha L
authors.initials: ML
authors.lastname: Daviglus
authors.forename: Norrina
authors.initials: N
authors.lastname: Allen
authors.forename: Lisa W
authors.initials: LW
authors.lastname: Martin
authors.forename: Jennifer
authors.initials: J
authors.lastname: Robinson
authors.forename: Marcia L
authors.initials: ML
authors.lastname: Stefanick
mesh_terms: D000368:Aged; D002140:California / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000401:mortality / Q000523:psychology; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D017698:Postmenopause; D011788:Quality of Life; D012649:Self Concept; D011795:Surveys and Questionnaires; D016387:Women's Health