title: Angina pectoris: relation of epidemiological survey to registry data.
abstract: BACKGROUND
  Self-reported angina symptoms are collected in epidemiological surveys. We aimed at validating the angina symptoms assessed by the Rose Questionnaire against registry data on coronary heart disease. A further aim was to examine the sex paradox in angina implying that women report more symptoms, whereas men have more coronary events.
  
  
  METHODS
  Angina symptoms of 6601 employees of the City of Helsinki were examined using the postal questionnaire survey data combined with coronary heart disease registries.
  
  
  METHODS
  The self-reported angina was classified as no symptoms, atypical pain, exertional chest pain, and stable angina symptoms. Reimbursed medications and hospital admissions were available from registries 10 years before the survey. Binomial regression analysis was used.
  
  
  RESULTS
  Stable angina symptoms were associated with hospital admissions and reimbursed medications [prevalence ratio (PR), 6.75; 95% confidence interval (CI), 4.56-9.99]. In addition, exertional chest pain (PR, 5.31; 95% CI, 3.45-8.18) was associated with coronary events. All events were more prevalent among men than women (PR, 2.36; 95% CI, 1.72-3.25).
  
  
  CONCLUSIONS
  The Rose Questionnaire remains a valid tool to distinguish healthy people from those with coronary heart disease. However, a notable part of those reporting symptoms have no confirmation of coronary heart disease in the registries. The female excess of symptoms and male excess of events may reflect inequality or delay in access to treatment, problems in identification and diagnosis, or more complex issues related to self-reported angina symptoms.
authors: Department of Public Health, University of Helsinki, Finland. tea.lallukka@helsinki.fi
authors: Tea
authors: T
authors: Lallukka
authors: Kristiina
authors: K
authors: Manderbacka
authors: Ilmo
authors: I
authors: Keskimäki
authors: Harry
authors: H
authors: Hemingway
authors: Ossi
authors: O
authors: Rahkonen
authors: Eero
authors: E
authors: Lahelma
authors: Reunanen
authors: R
authors: Antti
mesh_terms: D000328:Adult; D000787:Angina Pectoris / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology*; D002317:Cardiovascular Agents / Q000191:economics; D003327:Coronary Disease / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology*; D016527:Drug Costs / Q000706:statistics & numerical data; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010343:Patient Admission / Q000706:statistics & numerical data; D015995:Prevalence; D012372:ROC Curve; D012042:Registries / Q000706:statistics & numerical data*; D012044:Regression Analysis; D015203:Reproducibility of Results; D057566:Self Report; D017678:Sex Distribution; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D002317:Cardiovascular Agents