We investigated the prevalence and correlates of angina pectoris in 6573 men and women aged 20-59 participating in the Italian National Multicenter Study on Risk Factors for Arteriosclerosis. In both sexes, the prevalence of angina pectoris, as assessed by the Rose questionnaire, increased sharply with age (from 0.8% to 5.1% for men and from 1.7% to 6.9% for women). In all age groups, there was a higher prevalence of angina pectoris for women than for men. In men, a strong positive association was found between angina pectoris and myocardial infarction (both by self-report and electrocardiographic documentation) and self-reported dyspnea. In women, myocardial infarction (self-reported), electrocardiographic-documented myocardial ischemia, intermittent claudication, and dyspnea were all associated with angina pectoris. In both sexes, angina pectoris was positively associated with body mass index. Males with diabetes had two times the prevalence of angina pectoris as males without diabetes; in females, diabetes was only weakly associated with angina pectoris. None of other major ischemic heart disease risk factors (blood pressure, serum lipids, or smoking) was associated with angina pectoris.