International Journal of Epidemiology, Vol 26, 508-515, Copyright © 1997 by International Epidemiological Association
CL Hart, GC Watt, G Davey Smith, CR Gillis and VM Hawthorne
BACKGROUND: In all 8353 women and 7058 men aged 45-64 took part in the
Renfrew/Paisley survey in 1972-1976. They formed a prospective cohort study
of a general population in the West of Scotland; an area with high
ischaemic heart disease (IHD) mortality rates. The objective of this study
was to investigate three indicators of pre-existing IHD and determine how
they predicted subsequent IHD mortality in females compared with males.
METHODS: Pre-existing IHD was ascertained by the Rose Angina questionnaire,
a question on severe chest pain indicating evidence of previous IHD and an
electrocardiogram at a screening examination. Mortality information for a
15-year follow-up period was available. RESULTS: Pre-existing IHD was
higher at older ages and was less common in women than men. The risks of
IHD mortality were doubled for those with a single cardiovascular indicator
compared to those without, and were increased to fourfold for those with
two or more indicators. Indicators of pre-existing IHD had high specificity
and low sensitivity for subsequent IHD mortality in both women and men, and
the positive predictive values for women in the oldest age group were
similar to those for men in the youngest age group. CONCLUSIONS: Each
indicator of pre-existing IHD was a useful predictor of subsequent IHD
mortality in both women and men, even though IHD mortality rates were lower
in women. The indicators obtained by questionnaire could be implemented in
the primary health care setting to identify quickly those at risk who would
benefit from further investigation and intervention.
ARTICLES
Pre-existing ischaemic heart disease and ischaemic heart disease mortality in women compared with men
Department of Public Health, University of Glasgow, UK.
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