TOPLINE:

Nearly half of older adults without diagnosed heart disease reported experiencing heart‑related symptoms. These symptoms were more common in women; people with lung disease, anxiety, low physical activity, or obesity; smokers; or those who lived alone and were linked to poorer quality of life (QOL).

METHODOLOGY:

• Researchers conducted a cross-sectional substudy using baseline data of a randomised trial for atrial fibrillation screening (NORSCREEN) to estimate how common cardiac-related symptoms were in older adults without diagnosed heart disease and how they related to QOL.
• NORSCREEN included adults aged 65 years or older with an elevated risk for stroke in Norway between September 2023 and June 2025. For this substudy, researchers identified 39,281 of those who reported no prior diagnosis of cardiac disease (median age, 75 years; 50.1% women).
• At baseline, participants completed a questionnaire reporting comorbidities and cardiac-related symptoms (fatigue, exertional shortness of breath, tachycardia, palpitations, syncope, or exertional chest pain), among other elements, and completed the RAND-36 questionnaire for QOL.
• The primary outcome was the prevalence of at least one cardiac-related symptom; secondary outcomes included the frequency of each symptom and associations with baseline characteristics and QOL.

TAKEAWAY:

• Overall, 43.5% of participants without diagnosed cardiac disease reported cardiac-related symptoms; fatigue was the most common symptom (25.9%), followed by exertional dyspnoea (18.9%) and tachycardia (15.6%).
• Factors independently associated with cardiac-related symptoms were female sex (adjusted odds ratio [aOR], 1.66; 95% CI, 1.58-1.75), physical inactivity (aOR, 1.43; 95% CI, 1.32-1.55), current smoking (aOR, 1.24; 95% CI, 1.12-1.37), obesity (aOR, 1.18; 95% CI, 1.11-1.26), age below 75 years (aOR, 1.14; 95% CI, 1.08-1.20), and living alone (aOR, 1.13; 95% CI, 1.07-1.20).
• Participants with chronic obstructive pulmonary disease and anxiety had approximately sixfold and fourfold higher odds of having cardiac-related symptoms, respectively.
• Symptomatic participants had lower RAND-36 QOL scores than asymptomatic peers, with the largest differences noted in role limitations due to physical health (67.4 vs 87.6) and vitality (58.4 vs 74.3).

IN PRACTICE:

"Recognizing symptom prevalence not only highlights unmet clinical needs but also aids clinicians in evaluating these complaints, supporting comprehensive assessment and earlier detection of possible undiagnosed cardiac conditions," the researchers of the study wrote.

SOURCE:

This study was led by Jarle Jortveit, MD, PhD, Sørlandet Hospital, Kristiansand, Norway. It was published online on February 20, 2026, in European Heart Journal Open.

LIMITATIONS:

The cross-sectional design prevented causal inference and did not capture symptom timings, duration, or severity. All data were self-reported, without clinical or diagnostic confirmation. The study included individuals with access to digital tools, which may have limited the generalisability.

DISCLOSURES:

The NORSCREEN trial received funding from the Norwegian Regional Health Authorities. Several authors reported receiving speaking fees and consultant or lecture fees from various pharmaceutical and healthcare companies. One author reported being a shareholder and a partial employee of AppSens AS.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.