Meta-analysis: the epidemiology of noncardiac chest pain in the community

Aliment Pharmacol Ther. 2011 Jul;34(2):172-80. doi: 10.1111/j.1365-2036.2011.04702.x. Epub 2011 May 25.

Abstract

Background: Prevalence of, and risk factors for, noncardiac chest pain in the community have not been well studied.

Aims: To conduct a systematic review and meta-analysis to examine these issues.

Methods: MEDLINE, EMBASE and EMBASE Classic were searched (up to March 2011) to identify population-based studies reporting prevalence of noncardiac chest pain in adults (≥15 years) according to self-report, questionnaire or specific symptom-based criteria. Prevalence of noncardiac chest pain was extracted for all studies, and according to study location and certain other characteristics including presence or absence of gastro-oesophageal reflux disease (GERD) symptoms, where reported. Pooled prevalence overall, as well as odds ratios (OR), with 95% confidence intervals (CIs) were calculated.

Results: Of 18 articles evaluated, 16 reported prevalence of noncardiac chest pain in 14 separate populations, containing 24 849 subjects. Pooled prevalence of noncardiac chest pain in all studies was 13% (95% CI 9-16). The prevalence of noncardiac chest pain was higher in Australian studies and in studies using a questionnaire to define its presence, compared with those using Rome I or II criteria. Prevalence was no different in women vs. men (OR 0.99; 95% CI 0.82-1.20). The prevalence was markedly higher in subjects who also reported GERD (OR 4.71; 95% CI 3.32-6.70) and increased according to frequency of GERD symptoms.

Conclusions: Pooled prevalence of noncardiac chest pain in the community was 13%, but there were few studies. Rates did not appear to differ according to gender or age. Presence of GERD was strongly associated with noncardiac chest pain.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Chest Pain / epidemiology*
  • Chest Pain / physiopathology
  • Diagnosis, Differential
  • Gastroesophageal Reflux / epidemiology*
  • Gastroesophageal Reflux / physiopathology
  • Humans
  • Prevalence
  • Residence Characteristics
  • Risk Factors
  • Surveys and Questionnaires