RT Journal Article
SR Electronic
T1 Low Education as a Risk Factor for Undiagnosed Angina
JF The Journal of the American Board of Family
                Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 416
OP 421
DO 10.3122/jabfm.2012.04.110282
VO 25
IS 4
A1 Michael M. McKee
A1 Paul C. Winters
A1 Kevin Fiscella
YR 2012
UL http://www.jabfm.org/content/25/4/416.abstract
AB Background: Early awareness, recognition, and treatment of angina can help prevent or delay an acute myocardial infarction and potentially delay death. A patient's educational level may affect a physician's diagnosis of angina and/or a patient's symptom recognition. The objective of this study was to determine whether low education is a risk factor for undiagnosed angina. Methods: This was a cross-sectional observational study based on data from the National Health and Nutrition Examination Survey 2001 to 2008, providing a nationally representative sample of adults ≥40 years of age with angina based on physician diagnosis, presence of angina symptoms based on the Rose Questionnaire, or both. Educational attainment (high school or less vs more than high school) was the independent variable of interest. Undiagnosed angina (angina symptoms in the absence of angina diagnosis) was the dependent variable. We used logistic regression to control for age, sex, race/ethnicity, income, and health care visit during the past year. Results: Low education was associated with undiagnosed angina (odds ratio: 1.43; 95% confidence interval: 1.01–2.03). Other undiagnosed angina predictors included being female, being black, and having no health care visit during the past year. Conclusions: Low education is associated with undiagnosed angina. These results underscore the need for providers to ask about angina symptoms and confirm patients' understanding of their angina diagnosis among those with low education.