Estimating angina prevalence in a managed care population

Area of Science:

• Cardiology
• Public Health
• Health Services Research

Background:

• Angina prevalence estimations are crucial for understanding cardiovascular disease burden.
• Managed care data offers a unique perspective on disease prevalence within specific populations.
• Previous estimates have varied, necessitating further investigation into reliable prevalence metrics.

Purpose of the Study:

• To estimate the prevalence of angina pectoris, coronary artery disease (CAD), and chest pain using managed care administrative data.
• To compare these estimates with published data, such as American Heart Association (AHA) figures.
• To project prevalence rates to the broader US population and analyze demographic trends.

Main Methods:

• Utilized managed care administrative data from 2000-2001.
• Applied three distinct definitions for prevalence: angina pectoris diagnosis codes, broader coronary artery disease (CAD) codes, and chest pain diagnosis codes.
• Calculated prevalence rates per 1000 members, comparing results across definitions, years, and demographic groups (gender, age).

Main Results:

• Prevalence rates per 1000 for angina pectoris were 12.3 (2000), 14.0 (2001), and 17.5 (2000-2001).
• Coronary artery disease (CAD) rates were 52.2, 59.9, and 65.4, respectively; chest pain rates were 63.4, 75.8, and 93.4, respectively.
• Rates were consistently higher in men than women and increased with age, consistent with US population projections. Managed care rates for angina pectoris were lower than AHA estimates.

Conclusions:

• Angina prevalence in the US is substantial, with significant numbers identified through managed care data.
• Managed care data suggest higher prevalence in men and older adults, contrary to some AHA findings, possibly due to data capture differences.
• The aging US population is expected to increase the number of angina patients, potentially escalating healthcare costs.