Chest pain in a multi-ethnic population: A community-based study on sex differences in chest pain prevalence and care contacts.

Objective: While chest pain is a common symptom, its prevalence among women and men across ethnic groups is unknown. Moreover, how chest pain is associated with general practitioner (GP) and cardiologist visits in women and men across ethnic groups, remains to be determined.

Design: We used baseline data on 12423 women and 9071 men from the multi-ethnic HELIUS cohort (Amsterdam, the Netherlands; 2011-2015). Using logistic regressions, we studied sex differences in chest pain prevalence across ethnic groups. Next, in those who reported chest pain in the past two years (henceforth; recent chest pain), we studied sex differences in GP, cardiologist, and any specialists visits, in total and by ethnicity. Analyses were adjusted for age, ethnicity (in the total population), socioeconomic factors, associated symptoms, clinical parameters, and lifestyle factors.

Results: Across most ethnic groups, women were more likely than men to report lifetime (33 % vs 29 %, p < .001) and recent chest pain (4.5 % vs 2.7 %, p = .001). In those with recent chest pain, women were more likely to have visited a GP, yet less likely to have visited a cardiologist, but not any specialist, compared to men. These differences were also observed in several sensitivity analyses, including in those with symptoms suggestive of typical Angina Pectoris.

Conclusion: Chest pain is more commonly reported in women than men across most ethnic groups. While men were less likely to have visited a GP than women, women were less likely to have visited a cardiologist. Combined, this suggests delays in care may occur at different points in the care trajectory for women and men.