Published online before print July 14, 2008, doi: 10.1161/CIRCULATIONAHA.107.752006
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(Circulation. 2008;118:491-497.)
© 2008 American Heart Association, Inc.
Health Services and Outcomes Research |
Patient-Reported Health Status in Coronary Heart Disease in the United States
Age, Sex, Racial, and Ethnic Differences
From the Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Ga (J.X., D.R.L.); Northrop Grumman, Atlanta, Ga (J.X.); Analysis Group, Inc, Boston, Mass (E.Q.W.); Division for the Application of Research Discoveries, National Heart, Lung, and Blood Institute, Bethesda, Md (Z.-J.Z.); University of Colorado at Denver (P.W.S.); and University of Toledo, Toledo, Ohio (L.Z.).
Correspondence to Jipan Xie, MD, PhD, Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Mailstop K-47, 4770 Buford Hwy NE, Atlanta, GA 30341–3717. E-mail jipan.xie{at}gmail.com
Received November 14, 2007; accepted May 29, 2008.
Background— Coronary heart disease (CHD) affects 15.8 million Americans. However, data on the national impact of CHD on health-related quality of life, particularly among people of different age, sex, racial, and ethnic groups, are limited.
Methods and Results— Using data from the 2000 and 2002 Medical Expenditure Panel Survey, we examined various measures of patient-reported health status, including health-related quality of life, in the CHD and non-CHD populations and differences in the measures among demographic subgroups. These measures included short-form generic measures (Short Form 12; Mental Component Summary-12 and Physical Component Summary-12) and EuroQol Group measures (EQ-5D index and EQ visual analog scale). Ordinary least-squares regressions were used to adjust for sociodemographic characteristics, risk factors, comorbidities, and proxy report. The adjusted difference between the CHD and non-CHD populations was –1.2 for Mental Component Summary-12 (2.4% of the score in the non-CHD population), –4.6 for Physical Component Summary-12 (9.2%), –0.04 for EQ-5D (4.6%), and –7.3 for EQ visual analog scale (9.0%) (all P<0.05). Differences among demographic subgroups were observed. Particularly, compared with whites, the differences between CHD and non-CHD in blacks were bigger in all measures except Physical Component Summary-12. A significantly bigger difference in Mental Component Summary-12 also was observed among Hispanics compared with non-Hispanics.
Conclusions— CHD is associated with significant impairment of health-related quality of life and other patient-reported health status in the US adult population. Differences in the impairment associated with CHD exist across different age, racial, and ethnic groups. In addition to preventing CHD, effective public health interventions should be aimed at improving health-related quality of life and perceived health status in the CHD population, especially the most vulnerable groups.
CLINICAL PERSPECTIVE
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Clinical Summaries
Circulation 2008 118: 465-466.[Extract] [Full Text]
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