Men with Angina at Twice the Risk of Heart Attack and Death Compared with Women

Friday, 7 August 2009

Men with angina are twice as likely to have a heart attack and almost three times as likely to suffer a heart disease-related death than women with the same condition, finds a study published in the British Medical Journal today. Led by Dr Brian Buckley of NUI Galway, the study is the first to link primary and secondary care data with mortality records to assess the risks of angina among men and women. In the United Kingdom, angina is common and is often the first manifestation of ischaemic heart disease. Recent estimates suggest that 4.8% of men and 3.4% of women aged over 16 in England have the condition, while in Scotland angina is reported to occur in 6.6% of men and 5.6% of women. It is therefore important for both patients and their clinicians to understand the risks following a diagnosis of angina. Researchers based in Scotland and Ireland identified 1,785 patients (average age 62 years) from 40 primary care practices in Scotland who were newly diagnosed with angina between January 1998 and December 2001. According to Dr Buckley, who is a Cochrane Fellow and researcher in Primary Care at NUI Galway and an Honorary Research Fellow at the University of Aberdeen, "Angina must be taken seriously. This research really shows how important it is for people with angina to change their lifestyle and take their tablets. This message is so important and is today reinforced by the fact that the British Medical Journal – one of the top medical journals in the world – published this research". The study showed that a number of characteristics, including being male, age, smoking and obesity, in people with a first diagnosis of angina are strongly associated with subsequent risk of a number of cardiac outcomes. These results suggest that appropriate control of risk factors and optimal use of preventative medical treatments should be aggressively pursued in patients with angina, the authors conclude. Underlying conditions, such as diabetes and high blood pressure, were recorded and cardiovascular risk factors, such as smoking and obesity, were also assessed. The postcode of each patient was also used to assign a deprivation status. Participants were tracked for five years. Being male, older and a smoker was associated with an increased risk of having a heart attack, while being male, older, obese and a smoker were each associated with an increased risk of death from heart disease or any other cause. The likelihood of having a procedure to open up blocked arteries, known as angioplasty (PTCA) or coronary artery bypass surgery (CABG), was also higher in men than in women. But, interestingly, neither procedure was associated with significantly improved survival. Dr Buckley added: "At a time when many people are naturally concerned about data protection, people may be interested to know that at no time were the researchers able to identify any of the patients involved - the information they worked with was entirely anonymous. This study illustrates the great value of using such anonymous clinical datasets to answer important research questions, in a rigorous way which protects patient confidentiality".
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