Cardiovascular risk in women with nonspecific chest pain

Chest pain is common, and often a specifi c cause fails to be diagnosed. There is particular concern that many women with a diagnosis of nonspecifi c chest pain (NSCP) may have atypical indications of coronary artery disease. Analysis of data from the Women's Health Initiative hormone therapy trials, amongst 24,834 postmenopausal women aged 50-79 years who were initially free of cardiovascular disease, found that NSCP was associated with a 139% (95% CI: 46-292%) increase in the risk of subsequent angina. Similar proportional increases in risk were found for cardiac surgery or interventions and nonfatal myocardial infarction. Thus, a diagnosis of NSCP in a woman, using current technology, does not rule out the possibility of increased coronary risk. It would be prudent to treat women with NSCP as being at a higher than average risk of cardiovascular disease