Feel healthy? You still may be at risk for heart disease

In the journals

Even if you believe you're in excellent health, you could still be at risk for a heart attack or stroke, suggests a study of more than 6,800 people, average age 62, published Feb. 15, 2019, in JAMA Network Open. At the study's beginning, participants rated their health as excellent, very good, good, or poor/fair. (More than half the men reported being in very good or excellent health.)

Next, everyone had a coronary artery calcium (CAC) scan, which detects plaque buildup in the arteries of the heart. The scores range from zero to 100 and higher, with zero meaning no plaque buildup is present and cardio-vascular disease risk is at its lowest.

The researchers found that self-rating of health does correlate with your risk of a future heart attack or stroke. However, it was not as strong a predictor as they expected. In fact, over all, people who felt they were in excellent health had only a 45% lower risk of having a heart attack or stroke compared with those who reported fair or poor health.

In comparison, CAC scores were a much stronger indicator regardless of health rating. For example, among those who reported their health as excellent, those who had a CAC score higher than zero were five times as likely to have a heart attack or stroke than those who had a CAC score of zero.

While the people who rated themselves healthy tended to exercise more and follow a healthy diet, the study suggests that you should not just rely on how you feel as a proxy for overall health, and you should continue to have regular check-ups and tests as needed.