Angina

Prevention

You can help to prevent angina caused by coronary artery disease by controlling your risk factors for clogged arteries:

• High cholesterol - Follow your doctor's guidelines for eating a diet low in fats and cholesterol and, if necessary, take medication to decrease your cholesterol.

• High blood pressure - Follow your doctor's recommendations for changing your diet and taking your medication.

• Smoking - If you smoke, quit. If you don't smoke, don't start.

• Diabetes - Monitor your blood sugar frequently, follow your diet, and take your insulin or oral medication as your doctor has prescribed.

It's also wise to exercise regularly and to maintain an ideal weight. If angina attacks are triggered by emotional stress, learning stress management or relaxation techniques may be helpful.

Treatment

When angina is caused by coronary artery disease, treatment usually includes:

• Lifestyle changes - Changes include weight loss for obese patients, therapy to quit smoking, medications to lower high cholesterol, a program of regular exercise to lower high blood pressure, and stress reduction techniques (for example, meditation and biofeedback ).

• Nitrates, including nitroglycerin - Nitrates are vasodilators (medications that widen blood vessels). They increase blood flow in the coronary arteries, and make it easier for the heart to pump blood to the rest of the body.

• Beta-blockers, such as atenolol (Tenormin) and metoprolol (Lopressor, Toprol-XL)- These medications decrease the heart's workload by slowing the heart rate and reducing the force of the heart's contractions, especially during exercise.

• Calcium channel blockers, such as nifedipine (Adalat, Procardia), verapamil (Calan, Isoptin, Verelan), diltiazem (Cardizem, Tiazac), amlodipine (Norvasc) - These medications may help to improve the efficiency of heart muscle function and may decrease the number and severity of episodes of chest pain.

• Aspirin - Because aspirin helps to prevent blood clots from forming inside narrowed coronary arteries, it can reduce the risk of heart attacks in people who already have coronary artery disease.

If lifestyle changes and drugs fail to ease angina, or if you have a high .risk of a heart attack, your doctor may recommend balloon angioplasty or coronary artery bypass surgery.