How To Prevent Angina

Angina, also called angina pectoris, is a type of chest pain produced by a reduction in blood flow to the heart. It is normally not life-threatening but it is a symptom that you are in danger of having a heart attack or stroke. Angina is considered as one of the symptoms of coronary artery disease (CAD), rather than a disease on its own.

Even though angina is very prevalent, it can be difficult to distinguish it from other types of chest pain, such as indigestion discomfort. If you are experiencing any inexplicable chest pain, consult your doctor right away to find out the cause.

Types of Angina 

There are many different types of angina such as stable, unstable, microvascular, and angina induced by a spasm in the coronary arteries (vasospastic or variant). The causes, signs and symptoms of angina and angina pain vary depending on the type of angina you’re experiencing1,2.

  • Stable angina: The most common type, happens when the heart works harder than usual,e.g. during exercise. It lasts for about 5 minutes and goes away when you rest. It follows a regular pattern and might last for months or years3,4.
  • Unstable angina: The main distinction between unstable and stable angina is that unstable angina does not have a regular pattern and usually occurs at rest. It is caused primarily by atherosclerosis, which is characterised by a blockage that prevents blood from reaching the heart. The pain can be intense and lingers for a long time, and it may keep on coming back3,4.
  • Microvascular angina: It is also known as cardiac syndrome X, as you have chest pain but no coronary artery blockage. Instead, it could be a sign of coronary microvascular disease (MVD), in which your smallest coronary arteries aren't working properly and your heart isn't getting enough blood. The chest pain lasts more than 10 minutes, and sometimes even more than 30 minutes. It is more common in people assigned female at birth (AFAB)4,5.
  • Prinzmetal or variant angina: It is rare, and frequently affects younger patients who have other types of angina. It could happen in the middle of the night while you are asleep or resting. The arteries in your heart suddenly tighten or narrow, causing severe pain4,5.

Signs and symptoms of angina 

The duration and triggers of these symptoms depend on the type of angina. Some can be relieved with rest, some last longer than 10 minutes, and some happen at night. Anyone who experiences severe or persistent chest pain should seek emergency care1-5.

  • Chest pain: feeling tight, dull or heavy around the chest, but it may spread to your arms, neck, jaw or back
  • Feeling sick
  • Fatigue
  • Sweating
  • Breathless
  • Cramping 
  • Indigestion

People AFAB are more likely to get microvascular angina and experience different symptoms as people assigned male at birth (AMAB):6

  • Nausea
  • Shortness of breath
  • Abdominal pain
  • Discomfort in the neck, jaw or back
  • Stabbing pain instead of chest pressure

Can you reverse angina? 

Unfortunately, you cannot reverse angina that is caused by heart diseases, but you can slow down the narrowing of your arteries. Your treatment will be determined by the extent of your heart's damage. With appropriate treatment and healthy lifestyle modifications, angina symptoms and the risk of developing more serious conditions can be controlled.

Many patients with angina have a high quality of life and go about their daily routines as usual. It is  critical to maintain a healthy lifestyle in order to prevent your angina from worsening3,4

Lifestyle factors

The following lifestyle factors have the greatest impact on increasing your risk of this chronic health condition. We will also look at what you can do to reduce your risk from today.

Nutrition 

A healthy diet is one of the most effective weapons you have in the fight against cardiovascular disease, as certain foods can alter your cholesterol, blood pressure, diabetes, and obesity.  Choose meals that are high in vitamins, minerals, fibre, and other nutrients while being low in calories.

According to the NHS EatWell Guide, fruit and vegetables should make up slightly over a third of your daily diet. Regulate your intake of sweets, sugar-sweetened beverages, and red meats. Try to include low-fat dairy products like chicken, fish, legumes, nontropical vegetable oils, and nuts.

Physical activity

Exercise regularly is good for your overall health. According to studies done by the American Heart Association, at least 150 minutes of moderate to intensive physical activity on a weekly basis can help lower blood pressure, cholesterol, and maintain a healthy weight. Even a few minutes at a time could be beneficial to your health. 

According to other studies, those who have even a moderate level of fitness are substantially less likely to die prematurely than those who have a poor level of fitness. In the case of angina, exertion is a common cause, so it is crucial to keep a steady pace and take frequent breaks.1

Overweight/Obesity

Obesity puts you at risk of insuline resistance, high cholesterol and high blood pressure. This can lead to type 2 diabetes – all of which increase your risk of heart disease. Your Body Mass Index (BMI) can help you determine whether or not your weight is healthy.

Using this BMI calculator, you can simply calculate your BMI. A BMI of 18.5 to 24.9 is regarded to be healthy. If you find your BMI is over 25, take action now and start losing weight. Try to coordinate exercise and balanced nutrition to manage your weight loss.1

Smoking 

Cigarette smoke contains substances that make the walls of your arteries sticky. These fatty materials can block your arteries and restrict the amount of room available for blood to move freely, resulting in cardiac problems like angina, stroke, and heart attack.1 It is never too late to reap the benefits of quitting smoking. 

According to the American Cancer Society, when you stop:4

  • Within 12 hours, the level of poisonous carbon monoxide in the body returns to normal.
  • After one year, your risk of heart attack is half that of a continuing smoker’s risk.
  • After 15 years, your risk of coronary heart disease is that of a nonsmoker’s risk.

If you have difficulty quitting smoking by yourself, check the NHS smoking cessation service, or seek help from your GP or local pharmacy.

Alcohol 

Moderate drinking has been demonstrated to help balance cholesterol levels and reduce blood clotting, which could help keep arteries from narrowing.5 However, excessive alcohol use can cause high blood pressure, cardiomyopathy, stroke, cancer, and other disorders.

It can raise triglyceride, or unhealthy fat levels and cause irregular heartbeats. Obesity, alcoholism, suicide, and accidents are all linked to excessive alcohol consumption. According to the NHS, you should drink no more than 6 pints of average-strength beer or 10 small glasses of low-strength wine per week, and it is better to split them in a few days.

Sleep 

According to the Sleep Foundation, sleep is critical for the body's recuperation and sleep deprivation has been linked to an increased risk of cardiovascular disease. For example, when sleep is disrupted, a rapid increase in heart rate and blood pressure can induce angina. Another study discovered that sleep deprivation causes atherosclerosis, as it triggers chronic inflammation in the heart, which contributes to plaque formation and artery stiffening.

Mental health

Keeping your emotional health balanced is crucial for your physical health. According to the CDC, numerous studies have demonstrated that mental health is linked to risk factors for heart disease, with the links occurring both directly through biological pathways and indirectly through dangerous health behaviors.

On the one hand, persons who have been depressed, anxious, or stressed for a long time may have physiological impacts on their bodies, such as increased cardiac reactivity, reduced blood flow to the heart, and elevated cortisol levels. These physiologic changes can eventually contribute to heart disease. Mental health issues may increase the likelihood of engaging in activities such as smoking, leading an inactive lifestyle, or failing to take prescribed medications, all of which raise the risk of developing heart problems, including angina.7

Conclusion on lifestyle factors

Angina caused by coronary artery disease is irreversible, so you should take action now to lower your risk of developing any related heart diseases. Lifestyle changes, such as a balanced diet, regular exercise, smoking cessation, moderate alcohol, enough sleep, and taking care of your mental health, all help lower your risk. 

Diagnostic testing

At Klarity we use the latest technology when it comes to diagnostic testing. Our home blood tests give you health insights and personalised recommendations. Find out which test you should take.

Blood tests can measure the amount of certain heart enzymes to confirm if a heart attack has occurred, determine the extent of damage, and provide information on the time it takes for the blood to clot. For example, a protein called troponin should be measured, as it is released when heart muscle cells are damaged, for example, in case of a heart attack. Blood tests also check fat, cholesterol, and sugar levels, which may be the risk factors for other heart diseases.

References

  1. Angina(Chest pain) [Internet]. www.heart.org. [cited 2022 Jan 16]. Available from: https://www.heart.org/en/health-topics/heart-attack/angina-chest-pain
  2. Angina - Causes, symptoms & treatments [Internet]. [cited 2022 Jan 16]. Available from: https://www.bhf.org.uk/informationsupport/conditions/angina
  3. Angina (Chest pain): Types, symptoms, and more [Internet]. 2020 [cited 2022 Jan 16]. Available from: https://www.medicalnewstoday.com/articles/8886
  4. Smoking cigarettes hurts your heart | michigan health blog [Internet]. [cited 2022 Jan 16]. Available from: https://healthblog.uofmhealth.org/heart-health/5-ways-smoking-hurts-your-heart
  5. Alcohol and chest pain: causes, symptoms | castle craig rehab | blog [Internet]. Castle Craig. 2019 [cited 2022 Jan 16]. Available from: https://castlecraig.co.uk/blog/2019/06/19/alcohol-chest-pain
  6. How sleep deprivation affects your heart [Internet]. Sleep Foundation. 2020 [cited 2022 Jan 16]. Available from: https://www.sleepfoundation.org/sleep-deprivation/how-sleep-deprivation-affects-your-heart
  7. CDC. Heart disease and mental health disorders | cdc. Gov [Internet]. Centers for Disease Control and Prevention. 2021 [cited 2022 Jan 16]. Available from: https://www.cdc.gov/heartdisease/mentalhealth.htm

Yuting Jiang

Master of Science in Pharmacy - UCL (University College London)
Dynamic Master of Pharmacy student driven by a passion for providing high-quality patient care. Engaged in rigorous programmes of professional development, refining a myriad of skills, including data, analytical, and numerical. Gained excellent multi-lingual communication skills used to great effect in developing strong, multidisciplinary relationships and in the confident presentation of research findings both verbally and in writing.

Klarity is a citizen-centric health data management platform that enables citizens to securely access, control and share their own health data. Klarity Health Library aims to provide clear and evidence-based health and wellness related informative articles.