The chronic chest pain of angina is more likely to be associated with heart attack and death for men than for women, researchers report today.
And obesity and smoking are key factors that lead to death amongst people with angina, write Dr Brian Buckley of the National University of Ireland, and colleagues on the website of the British Medical Journal.
Campaigners welcomed the new research, which they said showed that it was "never too late" for people with angina to change lifestyles.
Dr Mike Knapton, of the British Heart Foundation, said: "This study of 1,800 people living with angina in Scotland showed that those who were most likely to die from heart disease were male, older, obese or smokers.
"This is the first time this has been demonstrated in a large number of patients living in the community, rather than in hospital settings, and confirms that smoking and being obese greatly up your risk of dying from heart disease.
"This is good news for people living with angina, as it shows that it’s never too late for them to change their lifestyles, or to stop smoking."
About 6.6 per cent of men and 5.6 per cent of women in Scotland have the condition.
The researchers investigated the risk of heart attack, invasive heart surgery, and mortality among patients with angina. They followed 1,785 newly-diagnosed patients in Scotland for five years. Average age was 62 years.
Results showed that men had double the risk of heart attack and 2.8 times the risk of death from heart disease. Heart surgery was also more common for men, but was not associated with significantly improved survival.
Older age was also linked with heart attack, raised by about four per cent for every increasing year. Risk of death from heart disease and from all causes was raised by about nine per cent for every year.
Smoking was strongly linked to heart attack, and death from heart disease or any cause. Obesity doubled the risk of death but not heart attack.
The researchers write: "In patients with angina in primary care there is a significant association between male sex and subsequent acute myocardial infarction, death related to heart disease, or death from any cause."
They recommend that "optimal preventive treatments should be used in patients with angina", and point out that prevention of subsequent heart attacks is crucial in avoiding a significantly increased risk of death.
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