Background The risk of angina and its social determinants in the elderly in China are not well documented. We determined the prevalence and socio-economic predictors of angina in Chinese elderly using the Rose Angina questionnaire and doctor-diagnosed of angina.

Methods Using a standard interview method, we examined random samples of 4314 participants aged ≥60 years in Guangdong, Heilongjiang, Shanghai and Shanxi provinces during 2008–2009. An angina diagnosis was based on the Rose Angina questionnaire and a doctor-diagnosis. An age-sex adjusted logistic regression model was employed to determine the association between angina and sociodemographic variables.

Results The world age-standardised prevalence of angina using the Rose Angina questionnaire (n=246) was 5.74% (95% CI 5.00% to 6.47%); in men 3.69% (2.75% to 4.63%), in women 7.22% (6.15% to 8.29%). Corresponding values for doctor-diagnosed angina (n=282) were 6.54% (5.76% to 7.32%); in men 5.08% (4.00% to 6.17%), in women 7.67% (6.56% to 8.77%). There was a fair agreement between two diagnoses (overall κ=0.38, in men 0.35, in women 0.40; all p<0.001). For both measures the likelihood of a diagnosis of angina was greater in women, heavier body weight, higher BMI, cigarette smoking and hypertension. Doctor diagnosed angina was associated with higher levels of educational attainment and higher occupation class, living in an urban area, taller height, larger waist circumference and diabetes. A diagnosis of angina based on the Rose Angina questionnaire was associated with low income only.

Conclusions Older people in China may have a low prevalence of angina. The association between an angina diagnosis based on the Rose Angina questionnaire and low income, and between a doctor diagnosis of angina and high socioeconomic status and urban living suggests that significant health and care inequalities in cardiovascular medicine exist in China.