ArticleBMC public health2025
Gender disparities in delayed angina diagnosis: insights from 2001-2020 NHANES data.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- A Patient and Physician Perspective of Chronic Coronary Syndrome and Persistent Stable Angina in Brazil.Cardiology and therapy · 2026Review
- Acute coronary syndromes across the lifespan of women.NPJ cardiovascular health · 2026Review
- Female patients with vascular disease receive less medical optimization despite more health care utilization.Journal of vascular surgery · 2026Article
- Women's heart disease research in the netherlands: angina with non-obstructive coronary artery disease and beyond.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2025Review
- Sex-Based Disparities in Clinical Burden and Diagnostic Delay in COPD: Insights from Primary Care.Journal of clinical medicine · 2025Article
- Association between vitamin B6 status and liver fibrosis: evidence from NHANES 2005-2010.Frontiers in nutrition · 2025Article
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Authors and funding
6 authors.
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Abstract
backgroundWomen with coronary artery disease (CAD) are more likely than men to experience a delay in diagnosis, which is attributed to differences in clinical presentation. The objective of this study is to examine any persistent disparities in timely CAD diagnosis in the United States (U.S.) among women who present with clinically similar symptoms and demographic characteristics to their male counterparts.
methodsFrom the 2001 - 2020 National Health and Nutrition Examination Survey (NHANES) data, participants were categorized as having missed angina if they experienced angina and did not self-report a prior diagnosis of angina pectoris or CAD. We assessed the association between gender and missed angina using weighted multivariate logistic regression models representative of the U.S. POPULATION: Mortality follow-up data were available for participants up to December 31, 2018.
resultsOf 874 participants with missed angina, 551 (63%) were women and 323 (37.0%) were men. Baseline characteristics showed that women and men with missed angina were more likely than their diagnosed counterparts to be younger, of ethnic minorities, uninsured, and smokers. Women with missed angina were more likely to be in a relationship than diagnosed women, while the opposite pattern was observed in men. The odds ratio of missed angina in women compared to men was 2.61 (95% CI: 1.73, 3.94) after adjusting for age, race, education, body mass index, smoking, alcohol use, income, insurance, and comorbidities. Among participants who had a cardiac cause of death, the odds of missed angina in women compared to men was 3.02 (95% CI: 1.18, 7.75) in the adjusted model.
conclusionWomen with similar CAD symptoms to their male counterparts still have higher odds of going undiagnosed. This relationship extends to individuals who ultimately die of cardiac causes. Potential solutions to this disparity include addressing overgeneralized perceptions of differences in the prevalence and presentation of CAD between genders and exploring targeted screening programs for women with risk factors. Further research accounting for healthcare access and proximity to care is needed to support our findings. Timely recognition of CAD in women is essential to decreasing preventable mortality.
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