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Heart disease in women worse than previously thought

Angina, a common form of heart disease, is more dangerous for women than was previously thought, according to a new study published in the Journal of the American Medical Association (JAMA). The collaborative study, led by UCL (University College London) and funded by the British Heart Foundation, found that angina in women is as common as it is in men, in contrast to heart attacks (myocardial infarction) which have a higher rate in men. The findings suggest that the medical profession should pay more attention to thoroughly investigating and diagnosing women suspected of having angina.

UCL Professor Harry Hemingway and colleagues studied over 100,000 patients aged 45-89 years with angina using electronic health records. They found that each year, two women out of every 100 in the general population developed angina, as the first sign of heart disease. This makes angina much more common than heart attacks (the risks of which are usually measured per 1,000 population).

The study also found that for women, the diagnosis of angina is less frequently confirmed with tests, such as angiograms or treadmill exercise electrocardiograms. In the patients in the study, drug treatment aimed at relieving angina (nitrates) was prescribed solely on the basis of symptom history.

In the study, angina in women was also associated with increased death rates, where women diagnosed without the confirmatory test had significantly higher death rates from heart disease. Such women have often been dismissed as having a 'soft' subjective complaint, without real pathological changes in the heart. The study suggests that this attitude is incorrect.

Among women with angina and diabetes, the annual risk of a heart attack was particularly high and similar to the risk in men (about one in 10).

Professor Hemingway, from the UCL Department of Epidemiology and Public Health, says: "For women, angina is a more significant public health problem than many
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Contact: Jenny Gimpel
j.gimpel@ucl.ac.uk
44-207-679-9739
University College London
21-Mar-2006


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