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Prevalence of ischaemic heart disease in middle aged British men
Insights
Ischaemic heart disease is common in middle-aged British men, affecting one quarter. Many cases show no clear symptoms or electrocardiogram results, indicating higher prevalence than previously thought.
Area of Science:
- Cardiology
- Epidemiology
- Public Health
Background:
- Previous studies on ischaemic heart disease (IHD) prevalence often focused on occupational groups.
- A comprehensive understanding of IHD in the general population, particularly middle-aged men, is crucial for public health initiatives.
Purpose of the Study:
- To determine the prevalence of ischaemic heart disease in a representative sample of British men aged 40-59.
- To compare findings with previous studies and highlight the diagnostic challenges posed by overlapping symptoms and test results.
Main Methods:
- A population-based study involving 7735 men aged 40-59 from 24 British towns.
- Data collection utilized a combination of administered questionnaires and electrocardiography (ECG).
- Prevalence was assessed for myocardial infarction (MI) and angina, considering both symptomatic and ECG-defined cases.
Main Results:
- Overall, 25% of men exhibited evidence of IHD through questionnaire, ECG, or both.
- Questionnaire data indicated 14% had possible MI or angina, with significant overlap.
- ECG revealed IHD in 15% of men (4.2% definite MI, 10.3% possible ischaemia).
- Prevalence of MI and angina increased fourfold with age.
- A substantial number of men with symptomatic IHD lacked ECG evidence, and vice versa, highlighting diagnostic discordance.
Conclusions:
- The prevalence of ischaemic heart disease in middle-aged British men is higher than previously estimated from occupational studies.
- The study underscores the importance of considering both clinical history and objective diagnostic tools, acknowledging their limitations and overlap.
- Findings emphasize the need for revised public health strategies for cardiovascular disease prevention and management in this demographic.
Abstract:
The prevalence of ischaemic heart disease was determined by an administered questionnaire and electrocardiography in 7735 men aged 40-59 years drawn at random from general practices in 24 British towns. Overall, one quarter of these men had some evidence of ischaemic heart disease on questionnaire or electrocardiogram or both. On questionnaire, 14% of men had possible myocardial infarction or angina, with considerable overlap of the two syndromes. The prevalence of possible myocardial infarction combined with angina and of definite angina only showed a fourfold increase over the age range studied. Electrocardiographic evidence of ischaemic heart disease (definite or possible) was present in 15% of men, there being myocardial infarction in 4.2% and myocardial ischaemia in 10.3%. Electrocardiographic evidence of myocardial infarction increased fourfold over the age range studied. There was considerable overlap of questionnaire and electrocardiographic evidence of ischaemic heart disease. Nevertheless, more than half of those with possible myocardial infarction combined with angina had no resting electrocardiographic evidence of ischaemic heart disease, and half of those with definite myocardial infarction on electrocardiogram had no history of chest pain at any time. This national population based study strongly suggests that the prevalence of ischaemic heart disease in middle aged British men is greater than has been indicated by previous studies based on occupational groups.