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Long-term cardiovascular consequences of Rose angina at age 20–54 years: 29-years’ follow-up of the Tromsø Study
  1. Sidsel Graff-Iversen1,2,
  2. Tom Wilsgaard2,
  3. Ellisiv B Mathiesen3,
  4. Inger Njølstad2,
  5. Maja-Lisa Løchen2
  1. 1Norwegian Institute of Public Health, Oslo, Norway
  2. 2Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
  3. 3Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
  1. Correspondence to Professor Sidsel Graff-Iversen, Norwegian Institute of Public Health, Box 4404, Nydalen, 0403 Oslo, Norway; sgri{at}


Background The Rose Angina Questionnaire (RAQ) was constructed in the 1960s for assessing the population burden of angina. Studies have found that screening positivity by RAQ conferred an elevated risk of coronary heart disease (CHD). It is, however, not clear to what extent Rose angina represents early CHD in relatively young adults who are free of known CHD. If representing CHD, Rose angina is expected to carry prognostic information in addition to the risk conferred by other risk factors.

Methods The Tromsø Study is a population-based cohort study in Northern Norway. All men aged 20–54 years (n=8238) and women aged 20–49 years (n=8001), free of known cardiovascular disease (CVD), who participated in a survey 1979–1980, were followed throughout 2010 for incident myocardial infarction (MI), and for incident MI or stroke used as proxy for incident CVD. HRs were estimated using a Cox proportional hazard regression model.

Results In age-adjusted analyses, Rose angina predicted MI and CVD in both sexes. The excess risk was substantially accounted for by CVD risk factors, leaving no significantly elevated MI risk above the risk explained by these factors (adjusted HR 1.31; 95% CI 0.95 to 1.80 in men, HR 1.20; 95% CI 0.69 to 2.10 in women). A similar pattern was seen for CVD (adjusted HR 1.16; 95% CI 0.87 to 1.55 in men and 1.30; 95% CI 0.82 to 2.06 in women).

Conclusions Rose angina predicted MI and CVD in a 29-years’ follow-up of a relatively young population. Established CVD risk factors were important mediators.

  • Cardiovascular disease
  • Cohort studies
  • Epidemiology of cardiovascular disease

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