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Although men have higher rates of fatal heart attacks than women, women are about 20 percent more likely than men to suffer from chronic heart-related chest pain—angina—a new analysis shows.
“The female excess is remarkably consistent across countries with widely differing (heart attack) mortality rates, spanning four decades of study period and four decades of participant age,” investigators report in the American Heart Association’s journal Circulation.
Dr. Harry Hemingway, at University College London Medical School, and his associates conducted a systematic review of population studies that reported the prevalence of angina diagnosed using a standardized questionnaire.
Their analysis included 74 reports from 31 countries involving more than 400,000 subjects. This was the “first large-scale study investigating risk factors for stable angina,” according to a statement by the American Heart Association.
Altogether, there were 13,331 angina cases in women and 11,511 cases in men. Overall, the proportion of people with angina was 20 percent higher in women than men, and this was consistent in all the studies examined.
The global phenomenon of a female excess of angina, the authors say, implies “an inherent biological basis rather than artifactual explanations.”
“A key implication of the study is that being male is not a risk factor for developing stable angina—contrary to the long accepted view of physicians,” the AHA statement noted.
Hemingway and his team conclude: “Understanding the dichotomy of why men, who have a universal excess of fatal (heart attacks), do not have an excess of angina presents an important challenge for further research.”