Angina occurs when the heart does not get enough oxygen-rich blood. The condition, which is characterized by chest pain and discomfort in the shoulder, neck and back, is often mistaken for and misdiagnosed as indigestion because of its symptoms.

An incidence of angina, however, requires medical attention as it often serves as a warning of heart disease. It appears, though, that the rate of angina incidents in the U.S. has gone down, at least in older individuals and whites.

In the new study "National Trends in the Prevalence and Medical History of Angina: 1988 to 2012" published in the journal Circulation: Cardiovascular Quality and Outcomes on May 20, Julie Will, from the Division for Heart Disease and Stroke Prevention of the U.S. Centers for Disease Control and Prevention (CDC), and colleagues sought to determine whether or not there are changes in the prevalence of angina in black and white populations in the United States.

By using data from the National Health and Nutrition Examination Survey starting in 1988, the researchers found that the number of angina incidents in white individuals who were at least 40 years old for the period 2009 to 2012 was lower by about one-third when compared with the rate in the 2001 to 2004 period. The prevalence of angina in this particular group also dropped by 50 percent from 1988-1994 to 2009-2012. The prevalence of angina in black individuals, however, remains unchanged.

The researchers also noted that the number of women who were at least 65 years old who reported angina symptoms dropped by nearly 60 percent from 1988-1994 to 2009-2012. The decline in angina rate in men of the same age group for the same period, on the other hand, was more than 40 percent.

"Rates of angina symptoms and medical history of angina have declined among non-Hispanic whites and among adults aged ≥65 years," the researchers reported, adding that further study is needed to understand the declining incidents of angina. "Blacks have not experienced these same declines."

More effective interventions for preventing and controlling high blood pressure, diabetes and smoking cessation may be needed among blacks, Will said. The national data included too few Hispanics and other minorities to reveal angina trends among those groups.

Treatment for angina may depend on the severity of the problem. Mild angina, for instance, may only require lifestyle changes, while surgical treatments such as coronary artery bypass grafting (CABG) surgery may be needed for individuals with more serious angina.

"People often don't know that they have heart disease until it's too late," Will said. "Angina serves as a warning to both the patient and the doctor that a person may have underlying heart disease."

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