Table 1
Sociodemographic and risk factor distribution of participants in the Angina sample and History sample.
| ANGINA | HISTORY | |||||
|---|---|---|---|---|---|---|
| UNWEIGHTED N | UNWEIGHTED %/MEAN (SD) | WEIGHTED %/MEAN (SD) | UNWEIGHTED N | UNWEIGHTED %/MEAN (SD) | WEIGHTED %/MEAN (SD) | |
| Age | 6,459 | 50.0 (17.2) | 43.8 (16.7) | 6,513 | 50.1 (17.2) | 43.9 (16.7) |
| Sex | ||||||
| Male | 3,166 | 49.0 | 47.6 | 3,188 | 48.9 | 47.6 |
| Female | 3,293 | 51.0 | 52.4 | 3,325 | 51.1 | 52.4 |
| Ethnic group | ||||||
| Sinhala | 4,552 | 70.5 | 74.9 | 4,594 | 70.5 | 74.9 |
| SL Tamil | 1,266 | 19.6 | 12.5 | 1,273 | 19.5 | 12.5 |
| Indian Tamil | 203 | 3.1 | 2.8 | 205 | 3.1 | 2.8 |
| Muslim | 412 | 6.4 | 9.5 | 415 | 6.4 | 9.5 |
| Other | 26 | 0.4 | 0.3 | 26 | 0.4 | 0.3 |
| Sector | ||||||
| Rural | 3,566 | 55.2 | 70.6 | 3,590 | 55.1 | 70.6 |
| Urban | 1,939 | 30.0 | 19.6 | 1,960 | 30.1 | 19.6 |
| Estate | 166 | 2.6 | 0.6 | 168 | 2.6 | 0.7 |
| Rural/Estate | 788 | 12.2 | 9.2 | 795 | 12.2 | 9.2 |
| Education | ||||||
| No formal schooling | 245 | 3.8 | 2.8 | 252 | 3.9 | 2.8 |
| Primary educated | 903 | 14.0 | 9.9 | 914 | 14.0 | 10.0 |
| Secondary educated | 5,041 | 78.1 | 82.8 | 5,074 | 78.0 | 82.7 |
| Tertiary educated | 263 | 4.1 | 4.5 | 266 | 4.1 | 4.5 |
| Household SES quintile | ||||||
| Poorest | 1,535 | 23.8 | 19.6 | 1,547 | 23.8 | 19.6 |
| Poorer | 1,283 | 19.9 | 19.9 | 1,298 | 19.9 | 19.9 |
| Middle | 1,194 | 18.5 | 19.7 | 1,200 | 18.4 | 19.6 |
| Richer | 1,167 | 18.1 | 20.0 | 1,179 | 18.1 | 20.0 |
| Richest | 1,280 | 19.8 | 20.8 | 1,289 | 19.8 | 20.8 |
| Area SES tertile | ||||||
| Least developed | 2,349 | 36.4 | 33.2 | 2,367 | 36.3 | 33.2 |
| Middle | 1,851 | 28.7 | 33.6 | 1,862 | 28.6 | 33.6 |
| Most developed | 2,259 | 35.0 | 33.2 | 2,284 | 35.1 | 33.3 |
| Hypertension status | ||||||
| No | 4,216 | 65.3 | 73.0 | 4,246 | 65.2 | 72.9 |
| Yes | 2,243 | 34.7 | 27.0 | 2,267 | 34.8 | 27.1 |
| Diabetes status | ||||||
| No | 3,206 | 67.8 | 77.1 | 3,226 | 67.7 | 77.1 |
| Yes | 1,524 | 32.2 | 22.9 | 1,538 | 32.3 | 22.9 |
| Smoking status | ||||||
| Non-smoker | 4,872 | 77.2 | 79.2 | 4,911 | 77.2 | 79.2 |
| Ex- or current smoker | 1,439 | 22.8 | 20.8 | 1,450 | 22.8 | 20.8 |
| Total cholesterol (mean) | 6,386 | 206.2 (47.5) | 208.6 (46.9) | 6,440 | 206.1 (47.5) | 208.5 (46.9) |
| Cholesterol-to-HDL ratio (mean) | 6,384 | 4.3 (1.3) | 4.4 (1.3) | 6,438 | 4.3 (1.3) | 4.4 (1.3) |
| BMI | 6,412 | 23.8 (4.6) | 23.9 (4.6) | 6,465 | 23.8 (4.6) | 23.9 (4.6) |
| Waist-to-hip ratio (mean) | 6,429 | 0.9 (0.1) | 0.9 (0.1) | 6,483 | 0.9 (0.1) | 0.9 (0.1) |
Table 2
Prevalence of Angina+ and History+ by sociodemographic category.
| ANGINA+, % (95% CI) | HISTORY+, % (95% CI) | |||||||
|---|---|---|---|---|---|---|---|---|
| MALE | FEMALE | ALL | MALE | FEMALE | ALL | |||
| (n = 3,166) | (n = 3,293) | (n = 6,459) | (n = 3,188) | (n = 3,325) | (n = 6,513) | |||
| All | 1.9 (1.4–2.5) | 3.9 (3.0–4.8) | 3.0 (2.4–3.5) | *** | 4.0 (3.2–4.8) | 3.8 (2.9–4.6) | 3.9 (3.3–4.4) | |
| Age category | ||||||||
| <35 | 1.2 (0.1–2.2) | 1.9 (0.7–3.1) | 1.5 (0.7–2.3) | 0.5 (0.1–0.9) | 0.2 † | 0.4 (0.1–0.6) | ||
| 35–44 | 1.3 (0.2–2.3) | 3.7 (1.9–5.6) | 2.5 (1.4–3.7) | * | 1.5 (0.4–2.7) | 1.3 (0.2–2.4) | 1.4 (0.5–2.4) | |
| 45–54 | 2.1 (0.4–3.8) | 4.7 (2.2–7.2) | 3.5 (2.0–4.9) | 3.1 (1.3–4.8) | 2.6 (1.0–4.2) | 2.8 (1.8–3.8) | ||
| 55–64 | 2.8 (0.9–4.7) | 6.0 (3.6–8.4) | 4.5 (3.0–5.9) | * | 7.8 (4.9–10.7) | 8.4 (5.4–11.4) | 8.1 (6.2–10.1) | |
| 65–74 | 3.5 (1.4–5.5) | 6.7 (4.1–9.3) | 5.3 (3.7–7.0) | * | 14.5 (10.4–18.7) | 11.3 (8.0–14.6) | 12.6 (10.1–15.2) | |
| 75–84 | 5.4 (1.9–9.0) | 2.2 † | 3.7 (1.5–5.8) | 15.7 (9.7–21.7) | 13.8 (6.0–21.6) | 14.7 (10.5–18.8) | ||
| 85+ | 3.4 (1.0–5.8) | 5.0 † | 4.5 † | 12.1 † | 4.9 (0.4–9.4) | 7.2 (1.3–13.1) | ||
| Ethnicity | ||||||||
| Sinhala | 2.1 (1.4–2.9) | 4.2 (3.1–5.3) | 3.2 (2.5–3.9) | *** | 4.2 (3.2–5.2) | 3.6 (2.7–4.5) | 3.9 (3.3–4.5) | |
| Sri Lankan Tamil | 1.6 (0.8–2.4) | 1.1 (0.6–1.7) | 1.3 (0.8–1.9) | 3.8 (2.1–5.6) | 2.2 (1.0–3.5) | 3.0 (1.9–4.1) | ||
| Indian Tamil | 2.9 † | 11.6 (1.7–21.5) | 7.2 (2.2–12.2) | 0.8 † | 6.1 † | 3.4 † | ||
| Muslim | 0.7 (0.1–1.2) | 2.8 (0.2–5.5) | 1.8 (0.3–3.3) | 3.5 † | 6.5 (1.5–11.5) | 5.1 (2.4–7.8) | ||
| Other | 0.0 (0.0–0.0) | 13.2 (9.8–16.6) | 5.1 † | ** | 0.0 (0.0–0.0) | 13.2 (9.8–16.6) | 5.1 † | ** |
| Sector | ||||||||
| Rural | 2.0 (1.3–2.7) | 3.9 (2.9–5.0) | 3.0 (2.3–3.7) | ** | 3.5 (2.5–4.5) | 3.2 (2.3–4.1) | 3.3 (2.7–4.0) | |
| Urban | 1.4 (0.5–2.3) | 3.3 (1.6–4.9) | 2.4 (1.4–3.4) | 5.8 (4.0–7.5) | 6.3 (3.7–9.0) | 6.1 (4.6–7.5) | ||
| Estate | 4.3 † | 7.9 (2.7–13.2) | 5.8 (2.4–9.1) | *** | 1.9 † | 5.6 † | 3.4 (1.3–5.5) | |
| Rural/Estate | 2.3 † | 4.8 (0.9–8.6) | 3.4 (1.6–5.2) | 3.9 (1.9–5.9) | 2.8 † | 3.4 (2.0–4.8) | ||
| Education | ||||||||
| No formal schooling | 4.5 (2.7–6.2) | 4.7 (2.7–6.6) | 4.6 (1.3–7.9) | 3.1 † | 7.8 (0.7–15.0) | 6.3 (2.5–10.1) | ||
| Primary educated | 4.6 (1.7–7.5) | 7.9 (4.8–10.9) | 6.4 (4.6–8.1) | 6.4 (3.9–8.9) | 9.6 (5.7–13.6) | 8.1 (5.7–10.6) | ||
| Secondary educated | 1.5 (0.9–2.1) | 3.4 (2.4–4.3) | 2.5 (1.9–3.1) | *** | 3.9 (3.0–4.8) | 3.0 (2.3–3.8) | 3.4 (3.0–3.9) | |
| Tertiary educated | 3.4 (0.2–6.7) | 3.1 † | 3.3 (0.6–6.0) | 1.3 † | 0.8 † | 1.0 (0.1–2.0) | ||
| Household SES quintile | ||||||||
| Poorest | 2.8 (1.0–4.7) | 5.4 (3.0–7.7) | 4.4 (2.7–6.0) | 4.8 (2.9–6.8) | 3.2 (1.2–5.1) | 3.8 (2.6–5.1) | ||
| Poorer | 2.1 (0.8–3.3) | 4.1 (2.0–6.2) | 3.2 (2.0–4.5) | 2.6 (1.4–3.8) | 6.0 (3.3–8.7) | 4.5 (3.0–6.1) | * | |
| Middle | 1.9 (0.6–3.2) | 2.6 (0.9–4.3) | 2.3 (1.0–3.5) | 3.4 (1.4–5.4) | 3.0 (1.3–4.6) | 3.2 (1.9–4.4) | ||
| Richer | 1.9 (0.5–3.2) | 4.2 (1.6–6.8) | 2.9 (1.7–4.2) | 4.0 (2.3–5.6) | 3.8 (2.3–5.3) | 3.9 (2.9–4.8) | ||
| Richest | 1.3 (0.5–2.1) | 2.9 (0.8–5.0) | 2.0 (1.0–3.1) | 4.9 (2.9–7.0) | 2.9 (1.1–4.7) | 4.0 (2.8–5.2) | ||
| Area SES tertile | ||||||||
| Least developed | 2.8 (1.6–4.0) | 3.9 (2.8–5.1) | 3.4 (2.6–4.2) | 2.3 (1.5–3.2) | 3.2 (2.1–4.3) | 2.8 (1.9–3.7) | ||
| Middle | 1.4 (0.6–2.2) | 4.4 (2.0–6.7) | 3.0 (1.8–4.1) | ** | 4.2 (2.4–6.0) | 3.4 (1.9–4.9) | 3.8 (2.8–4.8) | |
| Most developed | 1.6 (0.8–2.3) | 3.4 (1.7–5.0) | 2.5 (1.5–3.5) | * | 5.5 (3.6–7.4) | 4.8 (3.0–6.5) | 5.1 (4.1–6.1) | |
[i] Notes: Data are weighted. Significance levels shown for difference between males and females (***p ≤ 0.001, **0.001 < p ≤ 0.01, *0.01 < p ≤ 0.05). CI Confidence Interval. †Confidence intervals not shown as lower bounds of CIs were below zero.
Table 3
Unadjusted and adjusted odds ratios for risk factors of Angina+ and History+ cases.
| ANGINA+ | HISTORY+ | |||
|---|---|---|---|---|
| UNADJUSTED ODDS RATIO (95% CI) | ADJUSTED ODDS RATIO (95% CI) | UNADJUSTED ODDS RATIO (95% CI) | ADJUSTED ODDS RATIO (95% CI) | |
| Age (years) | 1.49 (1.28–1.74) *** | 1.28 (0.97–1.68) | 3.02 (2.60–3.51) *** | 2.46 (1.92–3.15) *** |
| Gender | ||||
| Male | (Ref) *** | (Ref) *** | (Ref) | (Ref) |
| Female | 2.05 (1.4 –2.90) | 3.07 (1.64–5.75) | 0.95 (0.69–1.32) | 0.89 (0.59–1.33) |
| Ethnicity | ||||
| Sinhala | (Ref) *** | (Ref) ** | (Ref) | (Ref) |
| Sri Lankan Tamil | 0.40 (0.25–0.64) | 0.34 (0.20–0.60) | 0.76 (0.50–1.15) | 0.73 (0.43–1.25) |
| Indian Tamil | 2.33 (1.08–5.04) | 1.29 (0.40–4.11) | 0.86 (0.24–3.08) | 0.70 (0.18–2.80) |
| Muslim | 0.55 (0.23–1.34) | 0.43 (0.14–1.34) | 1.32 (0.73–2.39) | 0.95 (0.48–1.89) |
| Other | 1.62 (0.21–12.83) | 2.28 (0.37–13.93) | 1.33 (0.17–10.62) | 0.81 (0.14–4.62) |
| Sector | ||||
| Rural | (Ref) | (Ref) | (Ref) ** | (Ref) |
| Urban | 0.79 (0.49–1.29) | 1.27 (0.56–2.88) | 1.87 (1.35–2.58) | 1.43 (0.82–2.48) |
| Estate | 1.97 (1.02–3.80) | 2.33 (0.90–6.02) | 1.02 (0.52–1.99) | 1.28 (0.56–2.92) |
| Rural/Estate | 1.14 (0.63–2.06) | 0.86 (0.34–2.13) | 1.02 (0.64–1.62) | 1.57 (0.80–3.11) |
| Education level | ||||
| No formal education | (Ref) *** | (Ref) | (Ref) *** | (Ref) |
| Primary education | 1.41 (0.68–2.91) | 1.37 (0.56–3.37) | 1.33 (0.70–2.51) | 1.48 (0.58–3.77) |
| Secondary education | 0.53 (0.24–1.18) | 0.94 (0.36–2.42) | 0.53 (0.28–1.03) | 1.17 (0.43–3.18) |
| Tertiary education | 0.71 (0.23–2.19) | 1.23 (0.34–4.42) | 0.16 (0.06–0.43) | 0.32 (0.07–1.37) |
| Household SES quintile | ||||
| Poorest | (Ref) | (Ref) | (Ref) | (Ref) |
| Poorer | 0.73 (0.40–1.34) | 1.06 (0.46–2.45) | 1.19 (0.71–1.99) | 1.41 (0.76–2.64) |
| Middle | 0.51 (0.25–1.05) | 0.59 (0.24–1.48) | 0.82 (0.50–1.34) | 0.99 (0.50–1.95) |
| Richer | 0.66 (0.38–1.16) | 1.18 (0.51–2.72) | 1.02 (0.67–1.55) | 0.89 (0.49–1.63) |
| Richest | 0.45 (0.21–0.97) | 0.44 (0.16–1.22) | 1.05 (0.65–1.71) | 0.94 (0.47–1.90) |
| Area SES tertile | ||||
| Least developed | (Ref) | (Ref) | (Ref) ** | (Ref) |
| Middle | 0.87 (0.53–1.43) | 0.99 (0.53–1.84) | 1.38 (0.89–2.13) | 0.99 (0.57–1.70) |
| Most developed | 0.74 (0.46–1.19) | 0.71 (0.31–1.62) | 1.90 (1.28–2.82) | 1.30 (0.67–2.52) |
| Hypertension status | ||||
| No hypertension | (Ref) *** | (Ref) | (Ref) *** | (Ref) * |
| Hypertensive | 2.11 (1.51–2.95) | 1.58 (0.95–2.61) | 5.90 (4.34–8.04) | 1.94 (1.17–3.22) |
| Diabetes status | ||||
| No diabetes | (Ref) * | (Ref) | (Ref) *** | (Ref) *** |
| Diabetes | 1.66 (1.10–2.52) | 1.27 (0.81–1.98) | 3.82 (2.66–5.47) | 2.14 (1.46–3.13) |
| Smoking status | ||||
| Non-smoker | (Ref) | (Ref) * | (Ref) | (Ref) |
| Ex- or current smoker | 0.81 (0.55–1.17) | 2.09 (1.04–4.21) | 1.32 (0.95–1.84) | 1.20 (0.72–2.00) |
| Total cholesterol | 0.89 (0.77–1.03) | 0.88 (0.74–1.05) | 0.59 (0.48–0.73) *** | 0.58 (0.46–0.74) *** |
| Cholesterol-to-HDL ratio | 0.76 (0.63–0.91) ** | – | 0.66 (0.56–0.78) *** | – |
| BMI | 0.97 (0.82–1.15) | 0.92 (0.71–1.18) | 1.13 (0.98–1.31) | 1.06 (0.89–1.27) |
| Waist-to-hip ratio | 1.17 (0.97–1.41) | – | 1.51 (1.29–1.76) *** | – |
[i] Notes: ***p ≤ 0.001, **0.001 < p ≤ 0.01, *0.01 < p ≤ 0.05. CI Confidence Interval. Joint significance shown for categorical variables. Odds ratios for continuous variables age, total cholesterol, cholesterol-to-HDL ratio, BMI and waist-to-hip ratio shown for one standard deviation increase in that variable. Cholesterol-to-HDL ratio and waist-to-hip ratio are dropped from the adjusted model.
Figure 1
Comparison of smoothed IHD prevalence by age and gender, using Angina+ and History+ criteria with IHD prevalence estimates from Global Burden of Disease.
Notes: Smoothed prevalence by age are shown for Angina+, History+, and Angina+ or History+, fitting cubic splines with six knots to allow for non-linear relationships using weighted data for participants aged 18–80 years. Shaded regions represent 95% confidence intervals. GBD = Global Burden of Disease study, IHD = Ischaemic Heart Disease.