Survival in relation to angina symptoms and diagnosis among men aged 70-90 years: the Whitehall Study.
BACKGROUND
While the excess mortality associated with a diagnosis of angina, myocardial infarction in middle-aged individuals is well established, there is little available evidence on the natural history of angina in population-based studies of older people.


METHODS
We conducted a 5-year follow-up of 6655 older men aged 67-90 years (mean age 77 years) who participated in the Whitehall Study of London Civil Servants.


METHODS
Survival was examined in relation to a diagnosis of angina or myocardial infarction and to angina symptoms in a population-based study of older men living in the United Kingdom in the late 1990s.


RESULTS
Compared with men without a diagnosis of myocardial ischaemia (n=5219), a diagnosis of angina alone (n=617), myocardial infarction alone (n=421) or both (n=398) were associated with about a threefold, fourfold and sixfold higher risk of death from coronary heart disease, respectively. Median expectation of life at age 70 years was reduced by about 2, 5 and 6 years for those with angina, myocardial infarction, or both, respectively. Current symptoms of angina among those without previously diagnosed angina, was associated with a 2-fold higher risk of coronary heart disease mortality than those without either diagnosis or symptoms.


CONCLUSIONS
Both angina symptoms and diagnosis have a significant adverse effect on survival among men aged 70-90 years highlighting the importance of diagnosis and appropriate treatment of angina in old age.
Clarke
Robert
R
Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK. robert.clarke@ctsu.ox.ac.uk
Shipley
Martin
M
Breeze
Elizabeth
E
Collins
Rory
R
Marmot
Michael
M
Halsey
Jim
J
Fletcher
Astrid
A
Hemingway
Harry
H
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality*; D002423:Cause of Death; D003327:Coronary Disease / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008017:Life Expectancy; D008131:London / Q000453:epidemiology; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality; D011159:Population Surveillance; D015995:Prevalence; D016016:Proportional Hazards Models; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016019:Survival Analysis