For black men, the rates are 22.4, 33.8, and 39.5, and for black women, the rates are 15.3, 23.6, and 35.9, respectively.30 In a study conducted in Finland, the age-standardized, annual incidence of angina was 2.03 in men Further estimates of the prevalence of chronic, symptom- atic IHD can be obtained by extrapolating from data on ACS and, more specifically, AMI. About one half of patients presenting to the hospital with ACS have preceding angina.27 One current estimate is that about 50% of patients who suffer an AMI each year in the United States survive until hospi- talization.27 Two older population-based studies from Olm- sted County, MN, and Framingham, MA, examined the annual rates of MI in patients with symptoms of angina and reported similar rates of 3% to 3.5% per year.34,35 On this basis, it can be estimated that there were 30 patients with stable angina for every patient with infarction who was hospitalized, which represents 16.5 million persons with angina in the United States. However, since the data reported in these studies were collected, it is likely that the much greater use of effective medical therapies, including antiangi- nal medications and revascularization procedures, has re- duced the proportion of patients with symptomatic angina although there are still many patients whose symptoms are Fihn et al Stable Ischemic Heart Disease: Full Text e363 The costs of caring for patients with IHD are enormous, estimated at $156 billion in the United States for both direct and indirect costs in 2008. More than one half of direct costs are related to hospitalization. 