Researchers analysed hospital discharge records for Scottish residents aged at least 18 years with a first emergency hospitalisation for heart attack, angina, or other chest pain between 1990 and 2000.
Population hospitalisation rates for heart attack fell by a third between 1990 and 2000. In contrast, the rate for angina increased by 79%, for chest pain by 110%, and for any suspected acute coronary syndrome (heart attack, angina or chest pain) by 25%.
The decline in heart attack was much greater in men than in women in both young and older age groups. The increase in angina was slightly greater in men than in women in both age groups. For chest pain, the increases were comparable in men and women in both age groups.
The fall in hospitalisation rates for heart attack is consistent with reports from other countries, but contrasts with the rise in rates for angina and chest pain, say the authors.
The increase in hospitalisations for angina and chest pain has enormous implications for resources, finances, and services. For example, expansion of coronary intervention for increasing angina and development of observation units for chest pain to avoid admission of non-coronary chest pain, they conclude.