Association of health-related quality of life with cardiovascular risk factors and subclinical atherosclerosis in non-diabetic asymptomatic adults

Health-related quality of life (QoL) questionnaires represent easy-administered and useful tools in the medical clinical evaluation. An impaired health status seems to be associated with future cardiovascular (CV) events, but its role is not yet well established in asymptomatic subjects. The aim of our prospective study was to determine whether low values of health status (assessed by SF-36 questionnaire) were associated with CV or metabolic risk factors and future outcomes or with subclinical atherosclerosis in an urban population without CV diseases. We have evaluated 111 asymptomatic individuals, aged 35-75 years, 33.3% males. Each patient completed the SF-36 health survey and was evaluated comprehensively regarding CV risk factors; biochemical markers and the risk for developing CV or diabetes in the future by using SCORE and FINDRISC risk charts. Subclinical atherosclerosis was evaluated by measuring carotid intima-media thickness, ankle-brachial index, left ventricular mass index by echocardiography and aortic pulse wave velocity (PWV). After statistical analysis, female sex and obesity were correlated with low QoL levels. Age, blood pressure or other biochemical values were not associated with a decrease in QoL. Unlike SCORE, increased FINDRISC results were linked to low values both in mental and physical scores. Among subclinical atherosclerotic markers, only high values of PWV were related to a decrease of SF-36 survey on different scales. In conclusion, we recommend the use of easily-administered health status questionnaires in asymptomatic subjects since they bring additional data on CV and metabolic changes, starting with subclinical stages. Thus, early preventive measures could be initiated.