Chest pain in middle age tied to later heart events

By David Douglas

NEW YORK (Reuters Health) - Chest pain (also called angina) in middle age is associated with substantially increased risk of death, heart attack, heart failure and other cardiovascular events over the subsequent 20 years, Scottish researchers report based on a study of nearly 16,000 people.

"Angina is not the benign condition it is often thought to be, and we need to strive to treat it better," study chief Dr. John J. V. McMurray told Reuters Health. What is required "is not just to relieve the symptom but to prevent vascular events in the longer term."

McMurray and colleagues at the Western Infirmary, Glasgow followed 7,468 men and 8,354 women aged 45 to 64 years when they were recruited between 1972 and 1976. The subjects underwent comprehensive heart and circulatory system screening at study entry and it was determined that 669 of the men (9.5 percent) and 799 of the women (9.6 percent) had chest pain at that point.

At 20 years, death due to any cause for men with angina was 67.7 percent, compared to 45.4 percent of those without angina. In women, death due to any cause was 45.4 percent with chest pain versus 30.4 percent without.

Men with angina were also at increased risk of heart-related death or hospitalization, heart attack, or heart failure compared with men without angina. This was also true of women.

Compared to men with angina, women with angina were less likely to have a cardiovascular event or heart attack. However, there were no differences in risk of stroke, a dangerous heart arrhythmia known as atrial fibrillation, or heart failure.

McMurray went on to say that "things have begun to improve, but we really need to intensify efforts to ensure optimum use of current treatments and develop new treatments."

SOURCE: Heart December 2006.