Researchers discovered the unexpected result in the first large-scale study investigating risk factors for stable angina. They pooled data from 74 studies involving 401,315 people living in 31 countries, including the United States. Of the studies' participants, 13,331 women and 11,511 men had stable angina.

Compared to men, women develop angina more often in the small vessels of the heart than in the large coronary arteries. Physicians should reconsider how they view stable angina, Hemingway said. “If you think that narrowing of the large arteries is the only underlying cause, then that will color your judgment,” he said. “Such narrowing is less common in women than in men. But a woman with typical angina symptoms may still have myocardial ischemia.”

"Doctors and the general public should realize that out there in the real world, men and women experience these symptoms with a similar frequency," Hemingway said. "When someone sees their doctor with symptoms of angina, the sex of the patient is not the most important factor."

Angina is a common and serious heart problem. It's caused by inadequate oxygen to the heart, which can lead to chest pain or discomfort on exertion that typically goes away with rest. The condition can result from partially blocked heart arteries or decreased flexibility of the cardiac arteries.

Angina used to be considered a benign symptom in women, added Goldberg, who's the author of Dr. Nieca Goldberg's Complete Guide to Women's Health. "Maybe that's the thing that sent us on the wrong pathway that women didn't have heart disease,"

While risk factors for heart disease, such as smoking, differed from country to country, once the researchers compensated for those risk factors, they found that the prevalence of angina was still higher among women. In fact, the prevalence of angina was 20 percent higher overall among women than men.

Women have a higher prevalence of stable angina pectoris than men, according to a meta-analysis of nearly 25,000 cases in 31 countries, researchers reported in the online issue of Circulation.

Angina is chest pain caused by myocardial ischemia, an inadequate supply of blood-borne oxygen to the heart muscle. Patients with stable angina experience pain after exercise or stress, which disappears when they rest. The causes of stable angina are less understood than the causes of heart attack. But since stable angina is commonly the first sign of symptomatic heart disease, it is important to find out what causes it.

For the new study, Hemingway and his colleagues collected data from 74 studies involving 401,315 people living in 31 countries, including the United States. The prevalence of angina varied from country to country. Among women, the prevalence varied from 0.73 percent to 14.4 percent, with an average of 6.7 percent. Among men, it varied from 0.76 percent to 15.1 percent, for an average of 5.7 percent, the study found.

Chest pain is a common symptom which can be caused by many different conditions. Some causes of chest pain require prompt medical attention, such as angina, heart attack, or tearing of the aorta. Other causes of chest pain can be evaluated electively, such as spasm of the esophagus, gallbladder attack, or inflammation of the chest wall. Therefore, an accurate diagnosis is important in providing proper treatment to patients with chest pain.

Angina can be prevented by lifestyle changes (stopping smoking, increasing exercise) and by lowering blood pressure and cholesterol. The symptoms of angina can be relieved with medication (such as nitrates or beta-blockers) and by undergoing a coronary revascularisation procedure. The risk of having a heart attack after having experienced angina can be reduced by taking 'secondary prevention' medications such as aspirin and lipid lowering drugs. There is no cure for the underlying disease process of atherosclerosis.

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