Angina Facts and Statistics: What You Need to Know

Angina (angina pectoris) is a type of chest pain that is caused by a lack of blood flow to your heart muscle. Angina is a symptom of coronary artery disease (CAD), a common kind of heart disease that affects approximately 1 in 13 U adults in the United States. CAD is the leading cause of death in the U.S. 

This article will highlight important statistics and facts you need to know about angina.

Angina Overview

Angina is a type of chest discomfort or pain that happens when there is reduced blood flow to the heart. Angina is typically caused by a blockage in the coronary arteries that prevents oxygen-rich blood from flowing to the heart and the rest of the body. Many people with angina experience a squeezing sensation in their chest, as well as other parts of the body, such as the jaw, arms, or shoulders.

There are several different types of angina, including:

• Stable angina: Follows a pattern and typically occurs when the heart is under stress
• Unstable angina: Does not follow a predictable pattern
• Variant angina: Happens at rest

Over time, angina and CAD can lead to life-threatening complications. If left untreated, angina can increase the risk of a heart attack (myocardial infarction) or heart failure (when the heart is no longer able to effectively pump blood to the rest of the body).

How Common Is Angina?

Angina is common among adults in the United States. About 1 in 25 (4.1%) Americans aged 20 and older say they’ve been diagnosed with angina pectoris by a healthcare provider. 

Here are some other facts about the prevalence of angina in the U.S.:

• Just over 1 in 5 U.S. adults with a history of CAD experience angina at least once a month, and 1 in 8 adults with CAD experience angina on a weekly or daily basis.
• According to a 2018 survey, about 4.3% of U.S. adults have been told they have either angina or coronary heart disease (CHD), including about 1 in 14 adults in Puerto Rico and about 1 in 15 adults in West Virginia.
• Nearly one-half of middle-aged cisgender males and one-third of middle-aged cisgender females in the U.S. will experience symptoms of CAD.
• Data from the National Health and Nutrition Examination Survey (NHANES) suggests that rates of angina decreased from 4 million adults per year from 1988-1994 to 3.4 million adults per year from 2009-2012. However, this trend was true only among non-Hispanic White patients aged 40 and older. Among Black patients aged 40 and older, angina prevalence rates did not decrease.
• Among American adults aged 40 and older without health insurance, rates of angina increased from just under 1 in 20 adults in 2001-2002 to approximately 1 in 13 adults from 2011-2012. Among adults with health insurance, that trend was reversed—there was a decrease in angina rates from about 1 in 20 adults to around 1 in 13 adults over the same time.
  

Angina by Ethnicity

Angina rates in the U.S. vary somewhat by ethnicity. In particular, Black cisgender females and white cisgender males are more likely to be diagnosed with angina by a healthcare provider.

According to recent National Health and Nutrition Examination Survey (NHANES) data, these are the approximate angina prevalence rates among adults over 20 years old in the U.S.:

Angina by Age & Sex

The risk of developing angina increases with age. According to data from the National Health and Nutrition Examination Survey (NHANES) 2015-2018, fewer than 1 in 100 cisgender males and females ages 20-39 were diagnosed with angina, while more than 1 in 10 cisgender males and females over the age of 80 years old were diagnosed. 

Overall, cisgender males and females in the U.S. have similar rates of angina. NHANES data also showed that around 4.2% of cisgender males and 4.0% of cisgender females had been told by a healthcare provider that they had angina.

However, research has suggested that the prevalence rates of heart disease in cisgender females might be underestimated. Many people with angina who identify as women go undiagnosed—often for a long time—because they may not have the “classic” signs of heart disease.

Causes of Angina and Risk Factors

Angina is caused by coronary artery disease (CAD). Risk factors for CAD include:

• High blood pressure (hypertension)
• A family history of heart disease
• Smoking
• Diabetes
• High low-density lipoprotein (LDL) cholesterol levels
• Low high-density lipoprotein (HDL) cholesterol levels
• Obesity
• Being post-menopausal
• Being over the age of 45 (specifically for cisgender males)

Treatment can reduce the risk of complications from coronary heart disease, such as heart attack, heart failure, and stroke. 

Coronary heart disease is typically managed with lifestyle changes such as regular exercise and a nutritious diet, as well as medication to control cholesterol levels and blood pressure. Nitroglycerin might be prescribed to treat angina by increasing blood flow to the heart. In some cases, heart surgery is needed.

What Are the Mortality Rates for Angina?

People with angina have a significantly higher risk of life-threatening cardiovascular complications, such as heart attacks and heart failure. In the U.S., coronary artery disease is the leading cause of death.

Here are some statistics you need to know about angina-related mortality:

• Around 1 in 5 deaths in the U.S. are caused by heart disease.
• In 2020, about 382,820 people died from coronary artery disease.
• Around 1 in 5 annual CAD-related deaths occur in people under the age of 65.
• Coronary artery disease causes approximately one-third of all deaths of American adults over the age of 35.
• According to the AHA, the overall annual mortality rate from coronary heart disease is approximately 102.6 deaths per 100,000 people.
• Survival rates among patients with angina also vary according to their ejection fraction, which measures how much blood the heart can pump during each heartbeat. The 12-year survival rate for people with angina and an ejection fraction of greater than 50% is approximately 73%. The average 12-year survival rate for people with angina and an ejection fraction of less than 35% is 21%.
• Mortality rates from coronary heart disease have declined in the U.S. in recent years. From 2003-2013, the annual CAD-related death rate declined by 38%, while the overall number of deaths from CAD decreased by 22.9%. About half of the decline was related to improved treatment, including a therapy to increase blood flow in blocked arteries (revascularization).

Summary

Angina (angina pectoris) is chest pain caused by reduced blood flow to the heart muscle. Angina is a coronary artery disease (CAD), which can have fatal health complications like heart attack and heart failure. The risk of angina increases with age. The condition is more common among Black cisgender females and White cisgender males than among people in other racial groups. Cisgender males and females have similar rates of angina. While CAD is still the leading cause of death in the U.S., heart disease mortality rates have declined in recent decades.

A Word From Verywell

Angina can be hard to cope with, but you're not alone. It's a common condition and there are many of ways to get treatment. Talk to your healthcare provider if you experience symptoms you think could be from angina.