Angina is the first stage in coronary artery disease, or CAD. As the coronary arteries become blocked with fatty plaque, a process known as atherosclerosis, less blood and less oxygen are delivered to the heart muscle. At this stage, the amount of oxygen is typically enough to meet the needs of the heart muscle when the patient is at rest, but when the patient engages in activity, such as climbing stairs, it is insufficient. This lack of oxygen causes chest pain. The major causes of angina are high blood pressure, high cholesterol and cigarette smoking.
High Blood Pressure
High blood pressure, or hypertension, is one of the major causes of the atherosclerosis that leads to angina. Blood pressure is measured by two values: the systolic and the diastolic. The exact values that define high blood pressure have changed over time, but the most recent report of the Joint National Committee on hypertension defines a "pre-hypertension" state as a systolic pressure of 130 to 139 or a diastolic pressure from 80 to 89, with hypertension proper beginning with a systolic pressure of 140 or a diastolic pressure of 90. Regular check-ups with blood pressure screening are important for preventing atherosclerosis, since several medications for treating hypertension have been shown to reduce the incidence of heart disease
High Serum Cholesterol
Serum cholesterol refers to the particular type of complex particles, called lipoproteins, that the body uses to transport fats in the blood. High concentrations of density lipoprotein particles, or LDL, are associated with increased rates of atherosclerosis, while high concentrations of high density lipoprotein particles are associated with decreased rates. According to the most recent report of the National Cholesterol Education Program, the increased risk of heart disease begins with an LDL concentration of greater than 130 or an HDL concentration of less than 40. Regular cholesterol screening is also important for preventing angina, since several medications for treating high or low HDL have been shown to prevent heart disease.
Smoking
Cigarette smoking is the third major cause of the atherosclerosis that leads to angina. Cigarette smokers have rates of heart disease as much as 15 times greater than non-smokers, depending upon the number of cigarettes smoked daily and number of years as a smoker. There is no safe level of smoking, as even occasional "social smoking" increases risk. Nicotine is a highly addictive drug, and quitting smoking can be extremely difficult, but several effective treatments are available to make the process easier for smokers who are ready to stop.
References
- Express vesion of the JNC 7 report on hypertension
- "Harrison’s Principles of Internal Medicine"; Dennis L. Kasper; 2005
- Executive summary of the third NCEP report on the detection, prevention and treatement of high blood cholesterol in adults.
