Living with heart disease and angina
Heart Disease and Angina
Coronary heart disease (CHD) is a narrowing of the small blood vessels that supply blood and oxygen to the heart.
Angina is chest pain or discomfort that most often occurs when you do certain activities or feel stressed. It is caused by poor blood flow through the blood vessels of the heart muscle.
If you have high blood pressure, diabetes, or high cholesterol, your doctor may advise you to keep your:
- Blood pressure at 140/90 or lower (even lower if you have diabetes, kidney disease, or heart failure)
- LDL cholesterol level at 100 mg/dL or lower (even lower for some patients)
- HbA1c (for people with diabetes) at your recommended level
Living a Healthy Lifestyle
Some of the risk factors for heart disease that you CAN control are:
- Drinking alcohol. If you drink, limit yourself to no more than 1 drink a day for women, or 2 for men. Drinking more than this does more harm than good.
- Emotional health. Get checked and treated for depression, if needed.
- Exercise. Get plenty of aerobic exercise -- such as walking, swimming, or bicycling -- at least 30 minutes a day, 5 days a week.
- Smoking. Do not smoke or use tobacco.
- Stress. Avoid or reduce stress as much as you can.
- Weight. Maintain a healthy weight. Strive for a BMI (body mass index) between 18.5 and 24.9 and a waist smaller than 35 inches.
Eating a Healthy Diet
Good nutrition is important to your heart health, and it will help control some of your risk factors for heart disease.
- Eat plenty of fruits, vegetables, and whole grains.
- Choose lean proteins, such as skinless chicken, fish, and beans.
- Eat nonfat or low-fat dairy products, such as skim milk and low-fat yogurt.
- Avoid foods that contain high levels of sodium (salt).
- Read food labels. Avoid foods that contain saturated fat and partially hydrogenated or hydrogenated fats. These are unhealthy fats that are often found in fried foods, processed foods, and baked goods.
- Eat fewer foods that contain cheese, cream, or eggs.
Taking Your Medicines
Yourdoctor may prescribe medicine to treat CHD, high blood pressure, diabetes, or high cholesterol levels. These may include:
- ACE inhibitors
- Calcium channel blockers
- Diuretics (water pills)
- Statins to lower cholesterol
- Nitroglycerin pills or spray to stop an angina attack
To reduce your risk of a heart attack, your doctor may also advise you to take aspirin, clopidogrel (Plavix), or prasugrel (Effient) every day. Follow your doctor's directions carefully to keep heart disease and angina from getting worse.
Always talk with your doctor before you stop taking any of your medicines. Stopping these drugs suddenly or changing your dose can make your angina worse or cause a heart attack.
A Plan to Manage Angina
Create a plan with your doctor for managing your angina. Your plan should include:
- What activities are okay for you to do, and which ones are not
- What medicines you should take when you have angina
- What are the signs that your angina is getting worse
- When you should call your health care provider or 9-1-1
Know what can make your angina worse, and try to avoid these things. For example, some people find that cold weather, exercising, eating large meals, or getting upset or stressed worsens their angina.
Gaziano JM, Ridker PM, Libby P. Primary and secondary prevention of coronary heart disease .In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: ATextbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 49.
Mosca L, Benjamin EJ, Berra K, et al. Effectiveness-Based Guidelines for the Prevention of Cardiovascular Disease in Women--2011 Update: a guideline from the American Heart Association. Circulation. 2011;123(11);1243-1262.
Reviewed By: Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.