Angina in primary care in Goa, India: sex differences and associated risk factors
- 1Medical Research Council, General Practice Research Framework & Research Department of Primary Care & Population Sciences, University College London Medical School, London, UK
- 2Voluntary Health Association of Goa, Panjim, Goa, India
- 3Research Department of Mental Health Sciences, University College London Medical School, London, UK
- Correspondence to Professor I Nazareth, Department of Primary Care & Population Sciences, University College London Hampstead Campus, Rowland Hill Street, London NW3 2PF, UK;
Contributors IN and MK designed and led the study. IN had full access to the data and is responsible for the integrity and the accuracy of the data analysis. DN was responsible for the overall management of recruitment and follow-up of the study participants. EK was responsible for the statistical analyses. GD and RV were responsible for the organisation, training of data collectors and running of the study in Goa. All authors contributed to the final draft of the paper.
- Accepted 7 February 2010
Background Little is known about the prevalence of angina in people seen in Indian general practices. The authors assessed the prevalence of angina and its associated risk factors in Goan general practices.
Methods Cross-sectional study on consecutive attendees in nine private general practices in Goa, India. All participants completed the Rose Angina Questionnaire, to ascertain the presence of angina. Other demographic, clinical and biochemical data were also collected.
Results 1556 (626 men and 930 women) consecutive attendees aged 30 to 75 years. Angina was detected in 37 (5.9%, 95% CI 2.4 to 9.4%) men and 99 (10.6%, 95% CI=7.4 to 11.2%) women. The prevalence of angina increased with age in both sexes but was greater in women between aged 46–60 (OR=4.3 (95% CI 2.0 to 9.2)) when compared with men. When compared with men, the odds of angina in women of all ages was 2.03 (95% CI 1.10 to 3.75) after controlling for confounders. Angina was associated with depressive and/or anxiety symptoms in both sexes (men OR=5.65, 95% CI=2.25 to 14.16; women OR=2.18, 95% CI=1.01 to 4.69) and with hypertension in men (OR=3.82, 95% CI=1.57 to 9.30) and family history of coronary heart disease (OR=1.53, 95% CI 1.05 to 2.24) in women. Borderline/high total cholesterol levels (OR=0.5, 95% CI 0.28 to 0.89) in women were associated with a reduced risk of angina.
Conclusion Women attending general practices in Goa, India are at greater risk of angina than men. Depression/anxiety is strongly associated with angina. Greater awareness of the general practitioners to the disparity in angina between the sexes and its association with psychological distress is required.
Funding The research was funded through a grant given by the University College London, UK. The funders had no direct role in the design or conduct of the study, interpretation of the data, or review of the manuscript.
Competing interests None.
Ethics approval Ethics approval was provided by the Independent Ethics Committee in Mumbai.
Provenance and peer review Not commissioned; not externally peer reviewed.