Correlates of angina pectoris among men awaiting coronary by-pass surgery.

Biomedical, behavioral, and psychological correlates of angina pectoris were identified in 204 men awaiting coronary artery by-pass graft surgery. Angina was rated by use of a precoded series of interview questions. Four circumstances of anginal symptoms were investigated: exertional, emotional, post-prandial, and while resting or sleeping. These were uncorrelated with one another, except for exertional and post-prandial. Two-thirds of these patients experienced angina less often than daily in the most recent unrestricted month. Severity of coronary artery obstruction was not positively associated with frequency or severity of any type of angina, and were primarily behavioral and psychological. Disturbances of sleep, physical inactivity, history of cigarette smoking, distressed response to life crises, life dissatisfactions, hostility, use of propranolol, duration of cardiac illness, and age were among the predictors in the multiple regression equations. These results from selected by-pass candidates may apply more directly to such persons than to unselected community residents reporting angina symptoms. The findings suggest the need for greater focus on sources of variability in myocardial oxygen supply and demand in understanding the dynamics of angina episodes.