Suboptimal Health Status and cardiovascular deficits

Document Type

Book Chapter

Publication Title

Flammer Syndrome : From Phenotype to Associated Pathologies, Prediction, Prevention and Personalisation




School of Medical and Health Sciences




Wang, W., & Tan, X. (2019). Suboptimal Health Status and cardiovascular deficits. In O. Golubnitschaja (Ed.), Flammer syndrome (pp. 287-315). Springer. https://doi.org/10.1007/978-3-030-13550-8_17


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).



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