March 21, 2006

Chest pain equally common in women and men

NEW YORK -- Women have a similarly high incidence of stable angina -- chest pain due to inadequate blood flow to the heart -- as men, the results of a study released today indicate.

Moreover, "angina in women appears to be more serious than many doctors, or indeed the general public, realize," study chief Dr. Harry Hemingway from University College London Medical School told Reuters Health. "Angina in women is associated with an increased risk of dying from heart disease."

Yet despite this, women are less likely than men to be tested for angina. "Women who are told they have angina but who are not tested with a treadmill test or an angiogram should ask why," Hemingway said.

The researchers used Finland's comprehensive national healthcare database, which included 56,441 women and 34,885 men diagnosed with angina based having a nitrate prescription, and 11,391 women and 15,806. None of the patients had a history of coronary artery disease at study enrollment in 1998. They were following until 2004.

The investigators found a similar annual incidence of angina in women and men -- 1.89 and 2.03 per 100 population of all cases in women and men, respectively.

Unlike the marked male excess of heart attacks, this shows that "angina affects women as often as men," Hemingway's group notes in Journal of the American Medical Association.

The study also shows that, at every age, angina in women and men is associated with a similar increase in risk of death due to a cardiac cause relative to the general population without angina.

The incidence of "test-positive angina" was much lower in women than in men, confirming prior reports that women are less likely than men to undergo formal testing for chest pain, which is concerning, investigators point out, because women with test-positive angina are more likely to die from a cardiac cause than are men, according to the current study.

These findings, Hemingway and colleagues conclude, "demonstrate the public health importance of angina in women" and the need to ensure fair access to testing and treatment among women.

SOURCE: The Journal of the American Medical Association, March 22/29, 2006.