Rose angina predicts 23-year coronary heart disease mortality in women and men aged 40-49 years

Sidsel Graff-Iversen ^1*, Randi Selmer ¹ and Maja-Lisa Løchen ²

¹ Norwegian Institute of Public Health, Norway
² Institute of Community Medicine; University of Tromsø, Norway

^* To whom correspondence should be addressed. E-mail: sgri{at}fhi.no.

Accepted 11 June 2007

Abstract

Objective To determine the long-term coronary heart disease (CHD) mortality in women and men with symptoms according to the Rose Angina Questionnaire in relatively young age.

Design Cohort study with the baseline survey conducted during 1974-78. Information on symptoms was collected by a short, three-item version of the Rose Angina Questionnaire. Participants were re-invited to a similar survey five years later and followed for mortality throughout 2000.

Setting Three counties in Norway (the Norwegian Counties Study)

Participants 16 616 men and 16 265 women aged 40-49 years and denying CHD in 1974-78.

Main outcome measure CHD mortality during 23 years.

Results By the end of follow-up 1316 men (7.9%) and 310 women (1.9%) had died from CHD, including 16 % (66/406) of men and 4 % (24/563) of women with Rose angina in 1974-78. Rose angina implied an elevated mortality from CHD with adjusted hazard ratios 1.50 (95% CI 1.16-1.93) in men and 1.98 (95% CI 1.30-3.02) in women. According to calculations based on the Cox model these increases in risk are similar to those associated with elevations of total cholesterol by 1.8 mmol/l (men) and 2.5 mmol/l (women) or elevations of systolic blood pressure by 21 mm Hg (men) or 31 mm Hg (women).

Conclusions Angina symptoms in ages as low as 40-49 years were associated with elevated long-term CHD mortality in Norwegian women and men. This indicates that the three-item version of Rose Angina Questionnaire, although a screening tool rather than a diagnostic test, adds information on undiagnosed CHD in both sexes.

Keywords: angina, coronary disease, men, mortality, women

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