Previously undiagnosed angina pectoris in individuals without established cardiovascular disease: Prevalence and prognosis in the United States

Background: The prevalence and prognosis of previously undiagnosed angina pectoris (AP) in the absence of established cardiovascular disease (CVD) are unknown. This study sought to determine the prevalence and prognosis of previously undi-agnosed AP in the absence of established CVD in the United States.Methods: Data derived from the National Health and Nutrition Examination Survey (2001-2018) and the Rose Angina Ques-tionnaire (RAQ) were used to identify AP among participants >= 40 years without established CVD. Determinants of previously undiagnosed AP (AP undiagnosed prior to RAQ analysis) and predictors of all-cause mortality were identified using multivari-able logistic regression analysis and the Cox proportional hazard model.Results: Of the 27,506 participants eligible for analysis, 621 participants had previously undiagnosed AP. Thus, the preva-lence of previously undiagnosed AP was 1.99% (95% CI 1.79-2.20). Female gender, poverty, < high school education, hypertension, cigarette smoking, and obesity were independent predictors of previously undiagnosed AP. All-cause mortality rates were 1.71 per 1000 person months for participants with previously undiagnosed AP and were 1.08 per 1000 person months to those without previously undiagnosed AP (p = 0.003).Conclusions: The prevalence of previously undiagnosed AP in the United States is 1.99% in persons >= 40 years of age with-out established CVD. Previously undiagnosed AP in those without established CVD was an independent predictor of all-cause mortality.

Automated summary

The prevalence of previously undiagnosed angina pectoris (AP) in the absence of established cardiovascular disease (CVD) in the United States is 1.99% in persons aged 40 years and older. Previously undiagnosed AP in individuals without established CVD is an independent predictor of all-cause mortality.