Abstract 3306: Black, Hispanic, and White Women’s Symptoms of Coronary Heart Disease
Purpose: Although coronary heart disease is the number one killer of women, there is limited knowledge about prodromal and acute myocardial infarction (AMI) symptoms in women, especially minorities. The purpose of this study was to describe and compare prodromal and AMI symptoms in black, Hispanic, and white women.
Methods: From 13 sites, we recruited 1270 women: 545 (43%) black, 186 (15%) Hispanics, and 539 (42%) white. Using the McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey, we conducted telephone surveys 4 – 6 months post AMI about symptoms, risk factors, and comorbidities.
Analysis: We calculated the number of prodromal and acute symptoms for each woman. We compared the presence and absence of each symptom across ethnic groups using chi-square analysis following significant chi-squares with pair-wise comparisons. Using the risk score as a covariate, we used Analysis of Covariance to compare the number of symptoms and scores across ethnic groups.
Results: Nearly all women (94.6%) reported prodromal symptoms. Regardless of race, they most frequently experienced unusual fatigue and sleep disturbance. Eighteen symptoms differed significantly by race with black women reporting higher scores and frequencies of 15 symptoms than white and Hispanic women. Only 43.5% Hispanics, 39.4% blacks, and 30% whites reported prodromal chest pain/discomfort. The most frequent acute symptom was shortness of breath regardless of race while 22 acute symptoms differed significantly by race. Minority women reported significantly more acute symptoms than white women. After combining all locations of chest discomfort, it was the most frequent symptom for Hispanics (73%) and whites (58%), and the second most frequent for blacks (63%), but 27%– 42% respectively never experienced acute chest discomfort. When controlling for 11 comorbidities and risk factors, prodromal scores accounted for 39.9% of acute symptom scores.
Conclusions: Results suggest that racial groups have differences and similarities of the most frequently experienced prodromal and AMI symptoms. Minority women reported significantly more prodromal and AMI symptoms than white women. Further research is needed to determine which prodromal symptoms may be predictive of impending AMI.