Coronary artery disease - living with
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 (130/80 is better if you have diabetes, kidney disease, stroke, or heart problems.)
- Take statin medicines
- Keep your HbA1c and blood sugar at your recommended level
Living a healthy lifestyle
Some controllable risk factors for heart disease are:
- Drinking alcohol. If you drink, limit yourself to no more than 1 drink a day for women, or 2 a day for men.
- 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 for your heart health. Healthy eating habits will help you 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 non-fat 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
Your doctor 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 OK 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 doctor 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.
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Handler J, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014 Feb 5;311(5):507-520.
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.
Stone NJ, Robinson J, Lichtenstein AH, Bairey Merz N, Lloyd-Jones DM, et al. 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013 Nov 7. pii: S0735-S1097(13)06028-2.
Update Date 7/12/2012
Updated by: Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. A.D.A.M. Editorial Update: 05/14/2014