Related Experiment Video
Updated: Nov 2, 2025
Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
Published on: August 9, 2024
Prevalence of Angina Among Primary Care Patients With Coronary Artery Disease
Daniel M Blumenthal1,2,3, Sidney E Howard4, Jennifer Searl Como5
1Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston.
Insights
Over 21% of stable coronary artery disease patients experience monthly angina. Factors like race, smoking, and comorbidities influence angina frequency, highlighting the need for proactive symptom assessment in managing this condition.
Area of Science:
- Cardiology
- Public Health
Background:
- Angina pectoris significantly contributes to morbidity and mortality.
- Prevalence and frequency of angina in US adults with coronary artery disease (CAD) require further definition.
Purpose of the Study:
- To determine the prevalence and frequency of angina among stable outpatients with CAD.
- To identify demographic and clinical factors associated with angina frequency.
Main Methods:
- A cross-sectional survey was conducted using the Seattle Angina Questionnaire-7 (SAQ-7).
- Telephone-based administration of the SAQ-7 to a sample of adults with established CAD within a large US integrated primary care network.
- Data analysis involved univariable and multivariable regression to assess covariates.
Main Results:
- The study included 1612 respondents with a mean age of 71.8 years; 35.8% were women.
- 21.2% of respondents reported experiencing angina at least once monthly.
- Factors associated with more frequent angina included non-English/Spanish speaking, Black race, current/former smoking, atrial fibrillation, and COPD. Male sex, peripheral artery disease, and novel oral anticoagulant use were associated with less frequent angina.
Conclusions:
- A significant proportion of stable CAD outpatients experience monthly angina.
- Demographic and clinical factors are associated with angina frequency.
- Proactive assessment of angina symptoms and identification of high-risk patients may reduce morbidity.
Importance:
Angina pectoris is associated with morbidity and mortality. Angina prevalence and frequency among contemporary US populations with coronary artery disease (CAD) remain incompletely defined.
Objective:
To ascertain the angina prevalence and frequency among stable outpatients with CAD.
Design, Setting, And Participants:
This cross-sectional survey study involved telephone-based administration of the Seattle Angina Questionnaire-7 (SAQ-7) between February 1, 2017, and July 31, 2017, to a nonconvenience sample of adults with established CAD who receive primary care through a large US integrated primary care network. Data analysis was performed from August 2017 to August 2019.
Exposure:
SAQ-7 administration.
Main Outcomes And Measures:
Angina prevalence and frequency were assessed using SAQ-7 question 2. Covariates associated with angina were assessed in univariable and multivariable regression.
Results:
Of 4139 eligible patients, 1612 responded to the survey (response rate, 38.9%). The mean (SD) age of the respondents was 71.8 (11.0) years, 577 (35.8%) were women, 1447 (89.8%) spoke English, 147 (9.1%) spoke Spanish, 1336 (82.8%) were White, 76 (4.7%) were Black, 92 (5.7%) were Hispanic, 974 (60.4%) had Medicare, and 83 (5.2%) had Medicaid. Among respondents, 342 (21.2%) reported experiencing angina at least once monthly; among those, 201 (12.5%) reported daily or weekly angina, and 141 respondents (8.7%) reported monthly angina. The mean (SD) SAQ-7 score was 93.7 (13.7). After multivariable adjustment, speaking a language other than Spanish or English (odds ratio [OR], 5.07; 95% CI, 1.39-18.50), Black race (OR, 2.01; 95% CI, 1.08-3.75), current smoking (OR, 1.88; 95% CI, 1.27-2.78), former smoking (OR, 1.69; 95% CI, 1.13-2.51), atrial fibrillation (OR, 1.52; 95% CI, 1.02-2.26), and chronic obstructive pulmonary disease (OR, 1.61; 95% CI, 1.18-2.18) were associated with more frequent angina. Male sex (OR, 0.63; 95% CI, 0.47-0.86), peripheral artery disease (OR, 0.63; 95% CI, 0.44-0.90), and novel oral anticoagulant use (OR, 0.19; 95% CI, 0.08-0.48) were associated with less frequent angina.
Conclusions And Relevance:
Among stable outpatients with CAD receiving primary care through an integrated primary care network, 21.2% of surveyed patients reported experiencing angina at least once monthly. Several objective demographic and clinical characteristics were associated with angina frequency. Proactive assessment of angina symptoms using validated assessment tools and estimation of patients at higher risk of suboptimally controlled angina may be associated with reduced morbidity.
Related Concept Videos
01:29Angina III: Clinical Manifestations and Assessment
01:30Angina I: Introduction
01:20Angina V: Nursing Management
01:26Angina IV: Management
01:27Angina II: Classification
01:27Coronary Artery Disease V: Interprofessional Care