Rose angina predicts 23-year coronary heart disease mortality in women and men aged 40-49 years.
OBJECTIVE
To determine the long-term coronary heart disease (CHD) mortality in women and men with symptoms, according to the Rose Angina Questionnaire at a relatively young age.


METHODS
Cohort study with the baseline survey conducted during 1974-8. Information on symptoms was collected by a short, three-item version of the Rose Angina Questionnaire. Participants were re-invited to a similar survey five years later and followed for mortality throughout 2000.


METHODS
Three counties in Norway (the Norwegian Counties Study).


METHODS
16 616 men and 16 265 women aged 40-49 years and denying CHD in 1974-8.


METHODS
CHD mortality during 23 years.


RESULTS
By the end of follow-up 1316 men (7.9%) and 310 women (1.9%) had died from CHD, including 16% (66/406) of men and 4% (24/563) of women with Rose angina in 1974-8. Rose angina implied an elevated mortality from CHD with adjusted hazard ratios 1.50 (95% CI 1.16 to 1.93) in men and 1.98 (95% CI 1.30 to 3.02) in women. According to calculations based on the Cox model these increases in risk are similar to those associated with elevations of total cholesterol by 1.8 mmol/l (men) and 2.5 mmol/l (women) or elevations of systolic blood pressure by 21 mm Hg (men) or 31 mm Hg (women).


CONCLUSIONS
Angina symptoms in ages as low as 40-49 years were associated with elevated long-term CHD mortality in Norwegian women and men. This indicates that the three-item version of the Rose Angina Questionnaire, although a screening tool rather than a diagnostic test, adds information on undiagnosed CHD in both sexes.
Norwegian Institute of Public Health, Marcus Thranesgate 6, Box 4404 Nydalen, NO-0403 Oslo. sgri@fhi.no
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Graff-Iversen
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Selmer
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Løchen
D000328:Adult; D000787:Angina Pectoris / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D001794:Blood Pressure; D002784:Cholesterol / Q000097:blood; D003327:Coronary Disease / Q000097:blood / Q000401:mortality* / Q000503:physiopathology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D011379:Prognosis; D012423:Rural Health / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
D002784:Cholesterol