Angina Pectoris: Epidemiology and Risk Factors

Angina pectoris is of interest as a cause of disability and also because it is a marker for potential severe manifestations of coronary heart disease such as cardiac infarction or sudden death. However, the elucidation of its epidemiology is inherently difficult. It is not specific for coronary heart disease. Because it is a symptom the diagnosis cannot be validated. Clinical diagnosis is inconsistent. Standard questionnaires are more reliable but these produce different results according to minor changes in circumstances and wording. The variability of the disease means that incidence and prevalence measures are closely related to the exact method of measurement. Risk factors for angina pectoris are the same as those for coronary heart disease as a whole. The risk factors continue to predict major coronary events even when angina pectoris has developed. The angina revealed by population surveys is a much more mild, transient and less dangerous disease than that reported in clinical case series. The implication for the latter is that the results cannot be generalized unless the way in which cases are referred and selected is known.