Remission of clinical angina pectoris: the Framingham study

The anginal status of the Framingham cohort was ascertained in a uniform manner during 20 years of follow-up studies. There were 74 men and 84 women with newly acquired angina that was not complicated with other manifestations of coronary heart disease. Remission of new angina pectoris for at least 2 years occurred in 32 percent of the men and 44 percent of the women. In angina that had persisted for several years, the subsequent remission rates were lower (14 percent for men and 19 percent for women). The similarity of coronary risk attributes of subjects with transient or persistent angina supports the hypothesis that both conditions may be true manifestations of coronary artery disease. Persistence of symptoms seems to indicate a more severe form of the disease characterized by nonspecific S-T segment or T wave abnormalities. It is associated with a greater incidence of myocardial infarction and death than in subjects with transient angina. The generally high remission rates must be taken into account in considering drastic surgical or medical remedies for clinical angina pectoris. Also, other possible causes for the chest pain should be sought.