The association of angina pectoris with heart disease mortality among men and women by diabetes status: the Rancho Bernardo Study.
OBJECTIVE
To study the sex-specific association of angina pectoris with mortality in community-dwelling older adults with and without diabetes.


METHODS
Baseline prevalence of angina was evaluated in 822 men and 1184 postmenopausal women aged 50-89 years at the 1984-1987 Rancho Bernardo Study clinic visit, when an oral glucose tolerance test (OGTT) and the Rose angina questionnaire were administered. All-cause and coronary heart disease (CHD) mortality were assessed after an average follow-up period of 13.2 years. Sex-specific Cox proportional hazard models were used to examine the independent association of angina with mortality by glucose tolerance category.


RESULTS
At baseline, average age was 71 years for both sexes; 61 men (7.4%) and 142 women (12.0%) had angina. Overall, 129 men (15.9%) and 130 women (11.0%) had type 2 diabetes; 228 men (27.7%) and 357 women (30.2%) had impaired glucose tolerance (IGT). During follow-up, 485 men (59%) and 557 women (47%) died, of whom 103 men (21.2%) and 104 women (18.7%) had fatal CHD. Women with diabetes and angina had a 3-4-fold greater risk of dying from CHD than women with diabetes but without angina, independent of covariates. Women with angina and IGT had twice the risk of CHD mortality compared with women with IGT but without angina. A smaller increased risk of fatal CHD in men was not statistically significant.


CONCLUSIONS
Angina was associated with an increased risk of dying from CHD among women, especially among those who also had IGT or diabetes.
Carpiuc
Kimbach T
KT
Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, California 92093-0607, USA.
Wingard
Deborah L
DL
Kritz-Silverstein
Donna
D
Barrett-Connor
Elizabeth
E
D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000150:complications* / Q000453:epidemiology; D001786:Blood Glucose / Q000378:metabolism; D002140:California / Q000453:epidemiology; D003327:Coronary Disease / Q000453:epidemiology / Q000401:mortality*; D048909:Diabetes Complications / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D018149:Glucose Intolerance / Q000150:complications; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D016016:Proportional Hazards Models; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires
D001786:Blood Glucose