Repeatability and validity of the Rose questionnaire for angina pectoris in the Atherosclerosis Risk in Communities Study

Paul D. Sorlie, Lawton Cooper, Pamela J. Schreiner, Wayne Rosamond, Moyses Szklo

Research output: Contribution to journalArticlepeer-review

75 Scopus citations


Angina pectoris (AP) as determined by the Rose questionnaire was assessed in nearly 16,000 black and white men and women participating in the Atherosclerosis Risk in Communities Study, a population study of cardiovascular disease in four communities. The questionnaire was administered at yearly intervals and estimates of repeatability were made. Validity was assessed indirectly by comparing Rose AP to risk factors, prevalent heart disease, medication use, and thickness of carotid artery walls as measured by B-mode ultrasound, Using κ statistics for agreement of positive Rose AP determinations taken 1 year apart, white men show a higher level of agreement than white women (average κ 0.36 for white men, 0.30 for white women), and whites show a higher level of agreement than blacks (average κ 0.23 and 0.22 for black men and women, respectively). Rose AP that persists for more than one determination is associated with thicker carotid artery walls, greater amounts of cigarette smoking, greater prevalence of reported heart attack, and greater use of chest pain medications. A single determination of severe Rose AP is also associated with thicker carotid artery walls. These data suggest that multiple reports and the more severe grading of Rose AP (pain reported while walking on the level) are likely to indicate more severe disease; however, a single report using the Rose questionnaire appears valid, i.e., moderately associated with disease and risk factors, and appropriate for use in epidemiological studies.

Original languageEnglish (US)
Pages (from-to)719-725
Number of pages7
JournalJournal of Clinical Epidemiology
Issue number7
StatePublished - Jul 1996

Bibliographical note

Funding Information:
The ARIC Study is carried out as a collaborative study supported by Contracts NOI-HC55015, N01-HC55016, NOI-HC55018, NOI-HC55019, NOJ-HC55020, NOI-HC55021, and HO1 -HC55022 from the National Heart, Lung, and Blood Institute (Bethesda, MD). We are indebted to the following individuals for their contributions to the study and this article: Carherine Paton, Jeannette Bensen, M.Sc., Delilah Posey, Amy Haire of the University of North Carolina (Chapel Hill, NC); Bobbie J. Alliston, R.N., Faye A. Blackburn, Catherine W. Britt, Barbara L. Davis of the University of Mississippi Medical Center (Jackson, MS); Karen Birkholz, Dot Buckingham, Carolyne Campbell, Maxine Dammen of the University of Minnesota (Minneapolis, MN); Carol Christman, Melissa Minotti, Dorrie Costa, Joan Nelling of the Johns Hopkins University (Baltimore, MD); Vakrie Stinson, Pam Pffe, Hoang Pham, Teri Trevino of the University of Texas Medical School (Houston, TX); Sandra Sanders, Charles Erta Rhodes, Doris Epps, Selma Soyal of the Methodist Hospital (Houston, 7X); Regina &Lacy, Delilah Cook, Carolyn Bell, Teresa Crotrs, SUzanne Pillsbury of the BoPvman-Gray School of Medicine (Winston-Salem, NC) ; Ann Howard, Doris L. Jones, Sharon Kerick, Mark Park of theU niversity of North Carolina (Chapel Hill, NC); and Jane S. Chen of the National Heart, Lung, and Blood Insritute (Bethesda, MD).

Copyright 2017 Elsevier B.V., All rights reserved.


  • Angina pectoris
  • Atherosclerosis
  • Repeatability
  • Validation


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