Cardiovascular risk in women with nonspecific chest pain

Chest pain is common, and often a specific cause fails to be diagnosed. There is particular concern that many women with a diagnosis of nonspecific 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.