Is there an association of heartburn and epigastric pain to risk factors, morbidity and mortality from coronary heart diseases?

PURPOSE: This study was done to determine the incidence of near simultaneous appearance of heartburn and epigastric pain. Also to find if there was any association between these symptoms and several potential cardiovascular risk factors, cardiovascular morbidity and mortality. METHODS: The participants are from a population based cohort study, the Reykjavik study, 1967-1994. Cases were participants who within 12 months before examination acquired the symptoms heartburn and epigastric pain. Others in the comparison cohort didn't have these symptoms together and attended the study twice or more often. RESULTS: Three hundred men and 288 women developed both heartburn and epigastric pain in our study. The comparison cohort consisted of 3113 men and 2585 women. The incidence rate was highest 22,7/1000 personyears among women and 16/1000 person-years among men in the youngest age group 34-39 years. It decreased with increasing age. Both men and women with heartburn and epigastric pain have more often sought a doctor for gastrointestinal and heart problems and have more often been diagnosed with diseases in those organs than the comparison group (cross-sectional univariate analysis). After adjusting for several risk factors, a previous visit to a doctor for gastrointestinal and heart problems remain independent risk factors for acquiring the symptoms heartburn and epigastric pain along with taking analgesic medication among both genders (logistic regression). Predictive factors of the appearance of those symptoms were as follows: Being in the care of a physician because of heartburn and epigastric pain (both sexes), taking antihypertensives (men) and weight (women). Conversely height was protective among women. The symptoms didn't influence mortality figures in cases compared to others. CONCLUSION: The incidence of the symptoms heartburn and epigastric pain is highest in the youngest age cohorts and higher in women than in men. Participants with these symptoms seem to fall into two groups, one with alimentary tract disorders but the other with heart disorders.