Increased mortality among women with Rose angina who have not presented with ischaemic heart disease

V. Owen-Smith, Philip Christopher Hannaford, Alison Margaret Elliott

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background. Little is known about the clinical importance of disease that is not presented to healthcare services.

Aim: To determine the 5-year mortality among those with angina symptoms, known or not known by their general practitioner (GP) to have ischaemic heart disease (IHD).

Design: A prospective cohort study.

Setting. The study was conducted in the United Kingdom as part of the Royal College of General Practitioners' Oral Contraception Study.

Method. In 1994-1995 women (n = 11797) still under GP observation were sent a questionnaire that enquired about their smoking habits, other lifestyle issues, general health, and selected symptoms (including chest pain, assessed using the Rose angina questionnaire). The main outcome measure was the chances (odds) of dying during the next 5 years, among those with and without exertional chest pain, Rose angina or Rose myocardial infarction (MI), stratified by documented history of IHD.

Results overall, the lifetime prevalence of any exertional chest pain was 10.1% (95% confidence interval [CI] = 9.5 to 10.8); grade I Rose angina was 6.1916 (95961 CI = 5.6 to 6.6); grade II Rose angina was 1.3% (95% CI = 1.1 to 1.6); and Rose MI was 4.4% (95% CI = 4.0 to 4.9). The prevalence of each condition tended to increase with age social class, parity body mass index and documented history of IHD. The proportion of women documented as having IHD was 23% among those with any exertional chest pain, 21.7% for grade I Rose angina, 37.7% for grade II Rose angina, and 31.4% for Rose MI. Compared to women without Rose angina, significantly higher odds ratios for all-cause mortality were observed among women with grade I Rose angina and no documented history of IHD (adjusted odds ratio [AOR] = 1.71, 95% CI = 1.05 to 2.79); those with grade II Rose angina and documented IHD (AOR = 3.94, 95% CI = 1.58 to 9.83); and women with grade II Rose angina and no documented history of IHD (AOR = 3.35, 95% CI = 1.47 to 7.62).

Conclusions: Women with angina symptoms that have not been documented by their GP appear to have an increased risk of future mortality. Research is needed to determine the best way of identifying and managing these individuals.

Original languageEnglish
Pages (from-to)784-789
Number of pages6
JournalThe British Journal of General Practice
Volume53
Issue number495
Publication statusPublished - Oct 2003

Keywords

  • angina pectoris
  • ischaemic heart disease
  • mortality
  • health status
  • community
  • cohort study
  • research clinics program
  • questionnaire angina
  • general-practice
  • chest-pain
  • prevalence
  • men
  • diagnosis
  • population
  • Scotland
  • asthma

Cite this

Increased mortality among women with Rose angina who have not presented with ischaemic heart disease. / Owen-Smith, V.; Hannaford, Philip Christopher; Elliott, Alison Margaret.

In: The British Journal of General Practice, Vol. 53, No. 495, 10.2003, p. 784-789.

Research output: Contribution to journalArticle

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title = "Increased mortality among women with Rose angina who have not presented with ischaemic heart disease",
abstract = "Background. Little is known about the clinical importance of disease that is not presented to healthcare services.Aim: To determine the 5-year mortality among those with angina symptoms, known or not known by their general practitioner (GP) to have ischaemic heart disease (IHD).Design: A prospective cohort study.Setting. The study was conducted in the United Kingdom as part of the Royal College of General Practitioners' Oral Contraception Study.Method. In 1994-1995 women (n = 11797) still under GP observation were sent a questionnaire that enquired about their smoking habits, other lifestyle issues, general health, and selected symptoms (including chest pain, assessed using the Rose angina questionnaire). The main outcome measure was the chances (odds) of dying during the next 5 years, among those with and without exertional chest pain, Rose angina or Rose myocardial infarction (MI), stratified by documented history of IHD.Results overall, the lifetime prevalence of any exertional chest pain was 10.1{\%} (95{\%} confidence interval [CI] = 9.5 to 10.8); grade I Rose angina was 6.1916 (95961 CI = 5.6 to 6.6); grade II Rose angina was 1.3{\%} (95{\%} CI = 1.1 to 1.6); and Rose MI was 4.4{\%} (95{\%} CI = 4.0 to 4.9). The prevalence of each condition tended to increase with age social class, parity body mass index and documented history of IHD. The proportion of women documented as having IHD was 23{\%} among those with any exertional chest pain, 21.7{\%} for grade I Rose angina, 37.7{\%} for grade II Rose angina, and 31.4{\%} for Rose MI. Compared to women without Rose angina, significantly higher odds ratios for all-cause mortality were observed among women with grade I Rose angina and no documented history of IHD (adjusted odds ratio [AOR] = 1.71, 95{\%} CI = 1.05 to 2.79); those with grade II Rose angina and documented IHD (AOR = 3.94, 95{\%} CI = 1.58 to 9.83); and women with grade II Rose angina and no documented history of IHD (AOR = 3.35, 95{\%} CI = 1.47 to 7.62).Conclusions: Women with angina symptoms that have not been documented by their GP appear to have an increased risk of future mortality. Research is needed to determine the best way of identifying and managing these individuals.",
keywords = "angina pectoris, ischaemic heart disease, mortality, health status, community, cohort study, research clinics program, questionnaire angina, general-practice, chest-pain, prevalence, men, diagnosis, population, Scotland, asthma",
author = "V. Owen-Smith and Hannaford, {Philip Christopher} and Elliott, {Alison Margaret}",
year = "2003",
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journal = "The British Journal of General Practice",
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T1 - Increased mortality among women with Rose angina who have not presented with ischaemic heart disease

AU - Owen-Smith, V.

AU - Hannaford, Philip Christopher

AU - Elliott, Alison Margaret

PY - 2003/10

Y1 - 2003/10

N2 - Background. Little is known about the clinical importance of disease that is not presented to healthcare services.Aim: To determine the 5-year mortality among those with angina symptoms, known or not known by their general practitioner (GP) to have ischaemic heart disease (IHD).Design: A prospective cohort study.Setting. The study was conducted in the United Kingdom as part of the Royal College of General Practitioners' Oral Contraception Study.Method. In 1994-1995 women (n = 11797) still under GP observation were sent a questionnaire that enquired about their smoking habits, other lifestyle issues, general health, and selected symptoms (including chest pain, assessed using the Rose angina questionnaire). The main outcome measure was the chances (odds) of dying during the next 5 years, among those with and without exertional chest pain, Rose angina or Rose myocardial infarction (MI), stratified by documented history of IHD.Results overall, the lifetime prevalence of any exertional chest pain was 10.1% (95% confidence interval [CI] = 9.5 to 10.8); grade I Rose angina was 6.1916 (95961 CI = 5.6 to 6.6); grade II Rose angina was 1.3% (95% CI = 1.1 to 1.6); and Rose MI was 4.4% (95% CI = 4.0 to 4.9). The prevalence of each condition tended to increase with age social class, parity body mass index and documented history of IHD. The proportion of women documented as having IHD was 23% among those with any exertional chest pain, 21.7% for grade I Rose angina, 37.7% for grade II Rose angina, and 31.4% for Rose MI. Compared to women without Rose angina, significantly higher odds ratios for all-cause mortality were observed among women with grade I Rose angina and no documented history of IHD (adjusted odds ratio [AOR] = 1.71, 95% CI = 1.05 to 2.79); those with grade II Rose angina and documented IHD (AOR = 3.94, 95% CI = 1.58 to 9.83); and women with grade II Rose angina and no documented history of IHD (AOR = 3.35, 95% CI = 1.47 to 7.62).Conclusions: Women with angina symptoms that have not been documented by their GP appear to have an increased risk of future mortality. Research is needed to determine the best way of identifying and managing these individuals.

AB - Background. Little is known about the clinical importance of disease that is not presented to healthcare services.Aim: To determine the 5-year mortality among those with angina symptoms, known or not known by their general practitioner (GP) to have ischaemic heart disease (IHD).Design: A prospective cohort study.Setting. The study was conducted in the United Kingdom as part of the Royal College of General Practitioners' Oral Contraception Study.Method. In 1994-1995 women (n = 11797) still under GP observation were sent a questionnaire that enquired about their smoking habits, other lifestyle issues, general health, and selected symptoms (including chest pain, assessed using the Rose angina questionnaire). The main outcome measure was the chances (odds) of dying during the next 5 years, among those with and without exertional chest pain, Rose angina or Rose myocardial infarction (MI), stratified by documented history of IHD.Results overall, the lifetime prevalence of any exertional chest pain was 10.1% (95% confidence interval [CI] = 9.5 to 10.8); grade I Rose angina was 6.1916 (95961 CI = 5.6 to 6.6); grade II Rose angina was 1.3% (95% CI = 1.1 to 1.6); and Rose MI was 4.4% (95% CI = 4.0 to 4.9). The prevalence of each condition tended to increase with age social class, parity body mass index and documented history of IHD. The proportion of women documented as having IHD was 23% among those with any exertional chest pain, 21.7% for grade I Rose angina, 37.7% for grade II Rose angina, and 31.4% for Rose MI. Compared to women without Rose angina, significantly higher odds ratios for all-cause mortality were observed among women with grade I Rose angina and no documented history of IHD (adjusted odds ratio [AOR] = 1.71, 95% CI = 1.05 to 2.79); those with grade II Rose angina and documented IHD (AOR = 3.94, 95% CI = 1.58 to 9.83); and women with grade II Rose angina and no documented history of IHD (AOR = 3.35, 95% CI = 1.47 to 7.62).Conclusions: Women with angina symptoms that have not been documented by their GP appear to have an increased risk of future mortality. Research is needed to determine the best way of identifying and managing these individuals.

KW - angina pectoris

KW - ischaemic heart disease

KW - mortality

KW - health status

KW - community

KW - cohort study

KW - research clinics program

KW - questionnaire angina

KW - general-practice

KW - chest-pain

KW - prevalence

KW - men

KW - diagnosis

KW - population

KW - Scotland

KW - asthma

M3 - Article

VL - 53

SP - 784

EP - 789

JO - The British Journal of General Practice

JF - The British Journal of General Practice

SN - 0960-1643

IS - 495

ER -