National Trends in the Prevalence and Medical History of Angina: 1988 to 2012

Background-The prevalence of angina from 1971 to 1994 was relatively flat for whites and blacks. We ask whether the prevalence and medical history of angina have changed during 1988 to 2012. Methods and Results-We used the National Health and Nutrition Examination Survey data from 1988 to 2004 and the data from the six 2-year surveys from 2001 to 2012. We calculated trends in both crude and standardized prevalence rates for the Rose questionnaire on angina (symptomatology) and a question asking whether the respondent had ever been told by a medical professional that they had angina (medical history). In 2009 to 2012, there were on average 3.4 million (95% confidence interval, 2.8-4.0 million) people aged >= 40 years in the United States each year with angina (Rose questionnaire) and 4.5 million (95% confidence interval, 3.5-5.1 million) people with a medical history of angina. The burden of angina varied across age, race, and sex categories, and the pattern of variation differed by whether symptomatology or medical history was assessed. Statistically significant declines in the rates for both outcomes were noted, for the most part, in people aged >= 65 years. Age and sex standardized rates declined significantly for whites but not for blacks. Conclusions-Rates of angina symptoms and medical history of angina have declined among non-Hispanic whites and among adults aged >= 65 years. Blacks have not experienced these same declines. Clearly, additional study is required to understand these declines and to track the future cost and burden of angina in the US population.