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Angina
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What is Angina?
Angina (or angina pectoris, to give the disorder its full medical name) is the intense crushing or squeezing chest pain that results when the heart receives an insufficient amount of blood and oxygen. Also characterized as a tightness, heaviness, or aching in the chest, the pain of angina is usually located under the breastbone and may radiate to the shoulders, neck, arms (often the left one), or jaw. Lasting anywhere from 30 seconds to 15 minutes, an attack is generally triggered by physical exertion or stress, which increases the heart's need for oxygen, and is relieved by rest. The pain generally builds in intensity, hits a plateau, and then subsides.
Angina is a primary symptom of coronary artery disease, the gradual narrowing of the arteries that supply heart muscles with oxygenated blood. Coronary artery disease develops slowly, often with no symptoms at first. In time, and especially if the disease is not controlled through lifestyle changes and medications, angina attacks may increase in frequency, intensity, or duration, or they may be triggered by less exertion. Such changes in the pattern of angina attacks may signal an impending heart attack.
The traditional treatment for angina pain is nitroglycerin, a prescription drug that helps dilate blood vessels. Cardiologists use other medications as well to reduce the work load of the heart. All angina medications treat basically the symptom, not the cause of the problem. Dietary and lifestyle changes, combined, if necessary, with drugs to lower cholesterol and blood pressure, are the keys to slowing or halting the arterial damage that causes angina. Supplements can also play a role in the treatment of angina by helping to improve arterial health and heart function.
Key Symptoms
What Causes Angina?
Angina is a result of the narrowing of the coronary arteries caused by atherosclerosis--the buildup of cholesterol-rich fatty deposits, or plaques, on the inside of arterial walls. As plaques develop, the coronary arteries thicken and narrow over time, impeding the flow of oxygenated blood to the heart muscles. During rest, the narrowed arteries may still be wide enough to supply the heart with the oxygen it requires. But when physical activity, such as running or climbing stairs, increases the heart's need for oxygen, the narrowed arteries now fail to meet the demand, and angina results.
In some cases, angina attacks are not triggered by physical activity, but occur instead when a small blood clot forms on plaque-damaged arterial walls, temporarily blocking a coronary artery. Arterial wall spasms, possibly induced by smoking, extreme emotional stress, or exposure to cold air, may also produce angina.
High blood cholesterol is the primary cause of atherosclerosis, the medical term for the development of arterial plaque within and along the wall of the artery. Other factors that promote plaque formation include high blood pressure, smoking, obesity, lack of exercise, family history, diabetes, and stress.
Treatment and Prevention
Angina can be relieved with nitroglycerin and other nitrate drugs that help dilate blood vessels throughout the body and immediately reduce the workload of the heart. Placing a nitroglycerin tablet under the tongue at the start of an attack usually eases pain within minutes. Because the activities that trigger angina soon become predictable, a patient can also take nitroglycerin before engaging in such activities to ward off an attack.
Other medications used for angina are beta-blockers and calcium channel blockers. By separate mechanisms, each of these medications prevents angina attacks by reducing the work performed by the heart muscle. When the load is reduced, so is the heart's oxygen requirement. These drugs also reduce high blood pressure (a cause of atherosclerosis and angina) because the rate and force that the heart pumps is lowered.
To slow, halt, or even begin to reverse the coronary artery disease that causes angina, patients need to make fundamental dietary and lifestyle changes--stop smoking, lose weight, eat a healthy diet, start exercising--and be vigilant about taking any medications prescribed to lower cholesterol and blood pressure. In addition, supplements that benefit the heart and help keep arteries in good repair can be used (in combination or singly, but always under a doctor's supervision) to complement angina and other cardiovascular medications.
The same dietary and lifestyle changes recommended for the treatment of coronary artery disease are recommended for its prevention, along with regular monitoring of cholesterol and blood pressure levels.
Just a reminder: If you have a serious medical condition, it's always a good idea to check with your doctor before beginning a supplement program.
How Supplements Can Help
Vitamins C and E are both antioxidants that can help prevent cell damage. Vitamin E keeps LDL ("bad") cholesterol from oxidizing, which is the first step in the development of arterial plaque. Take vitamin C to help repair plaque-damaged arteries.
Add magnesium to your regimen to help prevent the coronary artery spasms responsible for some angina attacks.
Take one or more of the following amino acids, all of which have beneficial effects on the heart. Arginine is involved in the formation of nitric oxide, an arterial wall relaxer. Carnitine is an amino acid-like substance that improves the energy efficiency of heart muscle cells. The amino acid taurine helps regulate abnormal heart rhythm.
Consider taking as well the nutritional supplement coenzyme Q10, which helps improve heart function, and the herb hawthorn, which helps improve blood flow to the heart.
The essential fatty acids in flaxseed oil and fish oils promote arterial health and flexibility, and may help raise HDL ("good") cholesterol and reduce blood triglyceride levels, a risk factor for heart disease. In addition, fish oils reduce the risk of developing cardiac arrhythmias, which can occur when the circulation to the heart is threatened, as is the case with angina.
Self-Care Remedies
Stop smoking immediately. Avoid smoke-filled places.
Watch what you eat. Stick with a diet that's low in saturated fat, cholesterol, and salt, and high in fiber. Use flaxseed, canola or olive oil instead of butter. And if you drink alcohol, do it in moderation. Try to eat fish, especially an oily fish, such as salmon, mackerel, tuna, or sardines, at least two or three times a week.
If you are overweight, lose the excess pounds.
Exercise regularly. At least 30 minutes a day of aerobic exercise three times a week is the usual recommendation. If you haven't been exercising or are over 50, check with your doctor before starting an exercise program.
Promote relaxation and relieve stress. Mind/body techniques such as meditation, tai chi, and yoga may help control angina.
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