Suboptimal Health Status and Cardiovascular Deficits

Abstract

Suboptimal Health Status (SHS) is the subclinical, reversible stage of pre-chronic disease. It is the physical state between health and disease, characterised by the perception of health complaints, general weakness, chronic fatigue and low energy levels. We have developed a tool to measure SHS, Suboptimal Health Status Questionnaire-25 (SHSQ-25) which assesses five components of health: (1) fatigue, (2) the cardiovascular system, (3) the digestive tract, (4) the immune system, and (5) mental status. To date, the SHSQ-25 as a self-reported survey instrument has been validated in various populations, including African, Chinese and Caucasians, therefore generating an unprecedented opportunity for the early detection of chronic health conditions, namely, cardiovascular diseases and diabetes. Our studies suggest that SHS is associated with the major components of cardiovascular health. We investigated the association between SHS and cardiovascular health metrics (defined by American Heart Association) among Chinese. Participants in the largest quartile of ideal cardiovascular health (CVH) metrics showed a lower likelihood of having on optimal SHS score compared to those in the smallest quartile after adjusting for socio-demographic factors (age, gender, marital status, alcohol consumption, income level and education). Four metrics (smoking, physical inactivity, poor dietary intake and ideal control of blood pressure) were significantly correlated with the risk of SHS. The study indicated that ideal CVH metrics were associated with a lower prevalence of SHS, and the combined evaluation of SHS and CVH metrics allows the risk classification of cardiovascular disease, consequently contributing to the prevention of cardiovascular diseases from a preventive, predicative and personalised medicine perspective (PPPM).

Appendix 1: Suboptimal Health Status Questionnaire (SHSQ-25)

The following questions ask some events about your health during the last 3 months.

Answer every question by making the appropriate box with an ‘x’. You may choose from one of the following answers:

1	2	3	4	5
never or almost never	now and then	often	very often	always

How often is it, that you (your)	1	2	3	4	5
1. were exhausted without physical actives significantly increasing.	□	□	□	□	□
2. fatigue could not be substantially alleviated by rest.	□	□	□	□	□
3. were languid when working.	□	□	□	□	□
4. suffered from headaches .	□	□	□	□	□
5. suffered from dizziness .	□	□	□	□	□
6. eyes were aching and tired.	□	□	□	□	□
7. suffered from sore throat.	□	□	□	□	□
8. muscles or joints felt stiff.	□	□	□	□	□
9. have pains in shoulder/ neck / waist.	□	□	□	□	□
10. have heavy feeling in legs when walking.	□	□	□	□	□
11. got out of breath while sitting still.	□	□	□	□	□
12. suffered from sore throat.	□	□	□	□	□
13. were bothered by heart palpitation.	□	□	□	□	□
14. got poor appetite.	□	□	□	□	□
15. suffered from an upset stomach.	□	□	□	□	□
16. suffered from indigestion.	□	□	□	□	□
19. got tender fever or cold in-tolerance.	□	□	□	□	□
20. had difficulty in falling asleep.	□	□	□	□	□
21. had trouble with waking up during night.	□	□	□	□	□
22. had trouble with impairment in short memory.	□	□	□	□	□
23. could not respond quickly.	□	□	□	□	□
24. had difficulty in concentration.	□	□	□	□	□
25. were distracted for no reason.	□	□	□	□	□
25. were keyed up or jittery.	□	□	□	□	□
26. were caught with colds in the past 1 year.	□	□	□	□	□