Prevalence of coronary heart disease, associated manifestations and electrocardiographic findings in elderly Finns.
OBJECTIVE
to study the prevalence of coronary heart disease (CHD) and its clinical manifestations among Finnish elderly people in a cross-sectional epidemiological survey in the rural district of Lieto, southwestern Finland, with special emphasis on the overlap of CHD manifestations with electrocardiogram (ECG) findings and factors associated with CHD.


METHODS
observational population-based study.


METHODS
Health Centre in Lieto, Finland, 1990-91.


METHODS
488 men and 708 women aged 64-97 years.


METHODS
angina pectoris (AP) and dyspnoea were recorded using the London School of Hygiene cardiovascular questionnaires. Resting ECG findings were analysed and coded. Minnesota codes 1.1-1.3, 4.1-4.4, 5.1-5.3 or 7.1 were interpreted as ischaemic. The medical history of cardiovascular diseases was based on medical records.


RESULTS
the prevalence of AP was 9.1% [95% confidence interval (CI): 6.7-12.0] among men and 4.9% (3.5-6.8) among women. The respective figures for myocardial infarction (MI) were 13.9% (10.9-17.0) and 6.5% (4.8-8.6). Ischaemic ECG findings were common: 32.9% (28.7-37.1) of men and 39.3% (35.7-43.0) of women had such changes, whereas only a minority of them reported typical AP. The total prevalence of CHD, including AP, MI, past coronary artery by-pass operation or angioplasty or ischaemic ECG findings, was 37.7% (33.4-42.0) in men and 42.0% (38.3-45.6) in women. Among men, a higher prevalence of CHD was associated with increasing age [odds ratio (OR) 1.81; 95% .CI: 1.20-2.73] and a history of having smoked in the past (OR 1.66; 1.06-2.59), whereas among women it was associated with increasing age (OR 2.02; 1.48-2.77) and a lower educational level (OR 2.30; 1.37-3.86).


CONCLUSIONS
the prevalence of CHD among elderly people is high and the clinical picture of the disease is variable. The nature of CHD seems to be less severe among elderly women compared with men. Minor ECG changes, especially in the ST and T segments, are common with ageing and should not necessarily be interpreted as ischaemic. However, these findings combined with atypical chest pain or dyspnoea in an elderly person may indicate the possibility of CHD.
Oulu University Hospital and Department of Public Health Science and General Practice, University of Oulu, Finland.
M
M
Ahto
R
R
Isoaho
H
H
Puolijoki
P
P
Laippala
M
M
Romo
S L
SL
Kivelä
D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000453:epidemiology; D002637:Chest Pain / Q000453:epidemiology; D003327:Coronary Disease / Q000453:epidemiology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D004417:Dyspnea / Q000453:epidemiology; D004562:Electrocardiography; D005260:Female; D005387:Finland / Q000453:epidemiology; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D015995:Prevalence