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Chest Symptoms and Long-Term Risk of Incident Cardiovascular Disease
Kentaro Ejiri1, Yejin Mok1, Ning Ding2
1Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.
The American Journal of Medicine
|July 31, 2024
Summary
Chest pain and shortness of breath (dyspnea) are linked to long-term cardiovascular disease risk, including heart attack and heart failure. These symptoms help predict cardiovascular events beyond traditional risk factors.
Area of Science:
- Cardiology
- Epidemiology
- Public Health
Background:
- Cardiovascular disease (CVD) remains a leading cause of mortality worldwide.
- Early identification of risk factors is crucial for CVD prevention.
- Chest pain and dyspnea are common symptoms that may indicate underlying cardiovascular issues.
Purpose of the Study:
- To investigate the long-term associations of chest pain and dyspnea with incident cardiovascular disease.
- To evaluate the predictive value of these symptoms for specific CVD outcomes, including coronary disease, heart failure, atrial fibrillation, and stroke.
- To determine if chest pain and dyspnea improve CVD risk prediction beyond established risk factors.
Main Methods:
- Utilized data from 13,200 participants in the Atherosclerosis Risk in Communities study (1987-1989).
- Categorized chest pain using the Rose questionnaire and dyspnea using the modified Medical Research Council scale.
- Employed multivariable Cox models to assess associations with incident CVD over a median follow-up of approximately 27 years.
Main Results:
- Definite and possible angina were significantly associated with increased risk of myocardial infarction and heart failure.
- Dyspnea (grades 3-4) showed substantial associations with myocardial infarction and heart failure.
- Chest pain and dyspnea improved the prediction of overall CVD risk, excluding stroke.
Conclusions:
- Chest pain and dyspnea are independent predictors of long-term cardiovascular disease incidence.
- Chest pain evaluation should consider a broader spectrum of CVD beyond coronary artery disease.
- Dyspnea is an important symptom for cardiovascular risk assessment, particularly for myocardial infarction and heart failure.
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