You may be able to control your angina by making lifestyle changes and taking medication. Any conditions you have that are causing your angina, such as high blood pressure, may be treated as well as your angina symptoms.
There are many things you can do to help control your symptoms and stop your angina from causing further heart problems.
- If you smoke, stop. Speak to a doctor or pharmacist (chemist) for advice.
- If you’re overweight, try to lose excess weight.
- Eat a healthy, balanced diet that is low in saturated fat, salt and sugar and high in fibre, fruit and vegetables.
- Try to eat oily fish, such as sardines or salmon, once a week.
- Take regular exercise. Moderate aerobic exercise such as brisk walking, cycling or swimming is recommended. Get advice from a doctor or nurse on how much exercise you can do.
- Don’t exceed recommended limits for alcohol intake. Guidelines differ from country to country.
- Reduce stress where possible. You may find learning relaxation techniques will help you with this.
- Attend regular check-ups with your doctor to monitor your blood pressure and cholesterol levels.
- If you have diabetes, it’s important to closely control your blood sugar levels.
You may be prescribed medicines that can provide you with immediate relief from your symptoms.
- Glyceryl trinitrate (also known as GTN) is a medicine that works by widening your coronary arteries so that more blood can flow to your heart. It commonly comes as a spray (used in your mouth) or it can come as a tablet that you dissolve under your tongue. If glyceryl trinitrate doesn’t relieve your chest pain after 15 minutes, or if the pain comes back, call for emergency help.
- If you have unstable angina, you may be given aspirin (acetylsalicylic acid) as soon as you get to hospital. This prevents your blood from clotting and reduces your risk of having a heart attack.
- Heparin is another medicine that prevents your blood from clotting. You may be given heparin injections if you have unstable angina when you are in hospital.
You may also be given regular medicines to help control your symptoms and to try and prevent you from having further heart problems, such as a heart attack. You may be given more than one medicine.
- Aspirin. If you have stable angina, you may be prescribed a small daily dose of aspirin to reduce your risk of having a heart attack. However, aspirin may increase your risk of stomach problems, such as ulcers, so it’s not suitable for everyone. Your doctor will be able to give you further information.
- Angiotensin-converting enzymes (ACE) inhibitors (eg rampiril). These widen the coronary arteries to increase blood flow to your heart and help lower blood pressure.
- Beta-blockers (eg atenolol). These slow your heart rate and the pumping action of your heart. This reduces your heart’s demand for oxygen. Beta-blockers may not be suitable if you have asthma.
- Statins (eg simvastatin). These help to lower your cholesterol level and prevent fatty deposits building up in your coronary arteries. You may be given these even if your cholesterol level is normal to help prevent a heart attack.
- Clopidogrel. This is an antiplatelet medicine to help prevent your blood from clotting.
- Postassium-channel activators (eg nicorandil). These relax coronary arteries to increase blood flow.
- Calcium-channel blockers (eg nifedipine). These relax the coronary arteries and other blood vessels, and reduce how strongly your heart beats.
- Long-acting nitrates (eg isosorbide mononitrate). These widen the coronary arteries and increase blood flow to the heart. They are available as tablets or patches. If you take these too often, you can reduce their effectiveness so it’s important to follow your doctor’s advice on how to take this medicine.
Always ask your doctor for advice and read the patient information leaflet that comes with your medicine.
If you have severe angina, you may have a procedure called a coronary angioplasty or surgery.
This helps to improve blood flow to your heart and relieve the symptoms of angina. A coronary angioplasty widens your arteries by inflating a balloon in the narrowed or blocked coronary artery. A wire mesh tube called a stent is usually inserted to hold the coronary artery open.
Coronary artery bypass graft (CABG)
CABG is a type of surgery that involves taking a section of a blood vessel (graft) from your chest, leg or arm and attaching it to the affected coronary artery. This diverts the flow of blood around the narrowed or blocked coronary artery.
Availability and use of different treatments may vary from country to country. Ask your doctor for advice on your treatment options.
Many people can prevent angina by adopting a healthy lifestyle. This includes:
- not smoking
- losing excess weight
- doing regular physical activity for 30 minutes on at least five days a week
- eating a low-fat, high-fibre diet with plenty of fruit and vegetables
- only drinking alcohol in moderation