© 2004 by BMJ Publishing Group & British Cardiac Society
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ISCHAEMIC HEART DISEASE
Failure to diagnose angina is dangerous to the patient’s health 
In a study of > 11 000 patients, 1158 (11.4%) participants developed angina, and 813 (70%) had no evidence of diagnosis by a doctor at the time of the initial report. Undiagnosed patients had an increased risk of impaired physical functioning (age and sex adjusted odds ratio of 2.36, 95% confidence interval (CI) 1.91 to 2.90) compared with those who had neither angina nor myocardial infarction throughout follow up. Those with undiagnosed angina and an abnormality on ECG (15.5%) had an increased risk of death (hazard ratio 2.37, 95% CI 1.16 to 4.87). This was similar to the rate in those with diagnosed ischaemic heart disease.
Hemingway H, Shipley M, Britton A, Page M, Macfarlane P, Marmot M. Prognosis of angina with and without a diagnosis: 11 year follow up in the Whitehall II prospective cohort study. BMJ 2003;
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