This article is more than 5 years old. Information may no longer be current.
Angina prevalence declined in US elderly
The prevalence and medical history of angina declined from 1988 to 2012 among Americans aged at least 65 years and adults who are non-Hispanic white. However, the same decline was not observed among black Americans, researchers reported in a new study.
Researchers analyzed population-based data from the National Health and Nutrition Examination Surveys from 1988 to 2004, and the 2-year NHANES surveys from 2001-2002 to 2011-2012. The medical history data were compiled using responses to the Medical Conditions Questionnaire and the symptomatology data were compiled using responses to the Rose questionnaire. Prevalence rates were calculated for the population aged 40 years and older because the Rose questionnaire was not administered to people younger than 40 years.
Fewer angina symptoms reported
According to the study, an average of 4 million Americans aged at least 40 years (95% CI, 3.6 million-4.6 million) reported symptoms of angina each year from 1988 to 1994 vs. 3.4 million Americans per year (95% CI, 2.8 million-4 million) from 2009 to 2012.
A majority of those reporting angina symptoms were women (approximately 60%). Non-Hispanic whites comprised 79.2% of those reporting angina symptoms in the NHANES population-based data from 1988 to 2004; however, this decreased to 58.8% by the 2009-2010 and 2011-2012 surveys.
From 2001 to 2004, an average of 5.9 million Americans aged 40 years and older (95% CI, 5 million-7.2 million) reported a medical history of angina per year vs. 4.5 million Americans per year (95% CI, 3.5 million-5.1 million) from 2009 to 2012. Men and women were almost equally likely to report a medical history of angina, and the proportion of non-Hispanic whites among those reporting a medical history of angina was 84.6% in 2001-2004 and 79.5% in 2009-2012.
Crude prevalence rates of angina symptomatology were 2% to 3% for men and 3% to 4% for women aged 40 to 64 years, and 3% to 5% for men and 2% to 6% for women aged 65 years and older, according to the study findings. Crude prevalence rates of medical history of angina were 2% to 3% for men and women aged 40 to 64 years, and 8% to 11% for men and 5% to 9% for women aged 65 years and older. Rates of both angina symptomatology and medical history declined during the study period for adults aged at least 65 years, especially among women; the rate of women aged at least 65 years reporting a medical history of angina decreased by nearly half from 2001-2004 to 2009-2012.
For non-Hispanic whites, age- and sex-standardized rates for angina symptomatology declined in a linear fashion from 1988-1994 to 2009-2012 (P<.0001). The same trend was observed for age- and sex-standardized rates for medical history of angina (P<.001). However, in both cases, the rate remained relatively flat for non-Hispanic blacks, according to the researchers.
“Clearly, additional study is required to understand these declines and to track the future cost and burden of angina in the US population,” Julie C. Will, PhD, MPH, from the CDC’s division for heart disease and stroke prevention, and colleagues wrote.
Explanations sought
Possible reasons for the results include “a declining incidence of angina, increased mortality among patients with angina, a changing health care system that is less likely to diagnose angina and to report to patients that they have angina, or a combination of these factors,” Will and colleagues wrote. “There are no national data about trends in incident angina, and therefore other data may offer some insights.”
A possible explanation for the flat rate among blacks is that “risk factors are not declining as much for blacks as for whites,” including high BP, high cholesterol and diabetes, they wrote.
Disclosure: The researchers report no relevant financial disclosures.