Gender specific variations in the description, intensity and location of Angina Pectoris: A cross-sectional study

Ghezeljeh, Tahereh Najafi; Momtahen, Mahmoud; Tessma, Mesfin Kassaye; Nikravesh, Mansoureh Yadavar; Ekman, Inger; Emami, Azita

doi:10.1016/j.ijnurstu.2009.12.021

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Volume 47, Issue 8 , Pages 965-974, August 2010

Gender specific variations in the description, intensity and location of Angina Pectoris: A cross-sectional study

Tahereh Najafi Ghezeljeh
- Nursing and Midwifery Faculty, Iran University of Medical Sciences, Tehran, Iran
- PhD Candidate at Karolinska Institutet.
- Corresponding author at: Karolinska Institutet 23300, SE-141 83 Huddinge, Sweden; Iran University of Medical Science, Nursing and Midwifery Faculty, Yasemi Street, Valiasr avenue, Box 19395-4798, Tehran, Iran. Tel.: +46 76 2383967/+98 935 9838447; fax: +46 8 34 82 65/+98 21 88793805.
Mahmoud Momtahen
- Department of Cardiology, Rajaei Cardiovascular, Medical & Research Center, Tehran, Iran
Mesfin Kassaye Tessma
- Medical Statistics Unit, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Sweden
Mansoureh Yadavar Nikravesh
- Nursing and Midwifery Faculty, Iran University of Medical Sciences, Tehran, Iran
Inger Ekman
- Institute of Health and Care Sciences, the Sahlgrenska Academy at Gothenburg University, Sweden
Azita Emami
- College of Nursing, Seattle University, United States

Received 18 April 2009; received in revised form 11 December 2009; accepted 29 December 2009.

Abstract

Background

Some research suggests that men and women may experience Angina Pectoris (AP) differently. More research is needed to characterize AP symptoms by gender and to familiarize health care providers with them, to enable proper education, diagnostic evaluation and timely management.

Objective

This study examines gender differences in the description, intensity and location of AP in patients with CHD.

Design

A cross-sectional study was performed to compare AP patients according to gender.

Settings

This study was performed on patients residing in Tehran, who were being treated in a hospital and were admitted to cardiac units.

Participants

Five hundred patients with AP were selected. The participants were patients with AP who were diagnosed with CHD based on documented results from an angiography.

Method

Outpatients who were admitted to the cardiac units were screened. Informed consent was obtained from all study participants, who then completed the Iranian version of the AP characteristics questionnaire.

Results

Women were significantly more likely to feel pain in the left arm and hand, odds ratio 1.5 (95% CI=1.0–2.1, P=0.04), left scapula, odds ratio 2.3 (95% CI=1.6–3.5, P<0.001), and neck, odds ratio 2.8 (95% CI=1.9–4.1, P<0.0001), while controlling for demographic and clinical factors. Women were significantly more likely to choose the possible pain descriptors for describing their AP and reported significantly greater intensity than men for all the pain descriptors. Significantly higher scores for sensory, affective, total and NRS (Numeric Rating Scale) scores were observed in women (P<0.001). Multiple linear regression analyses revealed that gender remained a statistically significant predictor of pain scores and NRS, while controlling for demographic and clinical factors.

Conclusion

Women and men differ with respect to description, intensity and location of AP. Educating the general public and informing health care providers about gender variation in AP may help to decrease delays in seeking medical care.

Keywords: Chest pain, Coronary heart disease, Gender, Pain description, Pain intensity, Pain location