Angina – technically angina pectoris, which is Latin for chest pain – is chest pain that results from a decrease in the blood supply to the heart and/or an increased demand for oxygen by the heart caused by physical activity. It is a symptom of coronary artery disease and can predict a heart attack.
The most common symptom is chest pain brought on by physical activity or exercise. This feels like pain, pressure or fullness in the chest or indigestion. Some people feel pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms. Other symptoms of angina include:
- Shortness of breath
- Nausea or vomiting
- Sudden weakness
- Fast or irregular heartbeat
Types of Angina
- Stable. The most common type, it occurs when the heart is working harder than usual – during physical exertion or stress. The pain usually goes away with a few minutes of rest or with medication. Learn to recognize the pattern or warning signs and anticipate when it will occur. Attacks usually last five minutes or less.
- Unstable. It is a change in your usual pattern of stable angina. It happens when blood flow to the heart is suddenly slowed by narrowed vessels or small blood clots that form in the coronary arteries. Unstable angina is a warning sign that a heart attack may soon occur. It is an emergency. It may happen at rest or with light activity. It does not go away with rest or medication like nitroglycerin. Attacks can last up to 30 minutes.
- Variant. A rare type called variant (or Prinzmetal’s) angina is due to a spasm that tightens coronary artery walls thus slowing or stopping blood flow to the heart. But it has a distinctive pattern. It usually occurs when you are at rest, and there is no clear cause. It occurs more often at night, in the early morning hours, or at the same time of the day. The spasm often occurs where plaque has narrowed the coronary artery, but it can also occur in healthy coronary arteries. Variant angina episodes typically last 2 to 5 minutes and quickly subside with nitroglycerin. The pain can be severe.
Attacks of angina occur because the heart muscle is not getting enough oxygen because blood flow to the heart muscle is hampered by narrowed arteries. Angina and coronary artery disease in general, may result from one or more of the following:
- Atherosclerosis. Hardening of the arteries occurs when fat, cholesterol and other substances build up in the walls of arteries and form hard structures called plaques. Over time, these plaques can block the arteries, reducing blood flow to the heart. In atherosclerosis, blood vessels stiffen and reduce blood flow by 15 percent or more. Your heart has to work harder to make up the difference. Angina pain can result.
- High blood pressure (hypertension). Over the course of many years, untreated high blood pressure causes arteries to narrow. Hypertension also forces the heart to work abnormally hard, causing its tissues to stiffen, also impeding blood flow.
- High blood cholesterol levels. It’s clear that having too much total cholesterol and “bad” (LDL) cholesterol in your blood increases your risk for coronary heart disease, including angina. It absolutely contributes to the narrowing of the arteries.
- Spasm. This angina happens when a coronary artery suddenly contracts (spasms), reducing oxygen-rich blood flow to the heart. If severe, a spasm can block blood flow and cause a heart attack. Most people who have these spasms have coronary artery disease, though they don’t always have plaque in their arteries. Cocaine can cause coronary artery spasm and heart attack, but in most cases it is not known what triggers the spasms.
- Obesity. When you’re overweight, your heart has to work harder, straining it over time. People with excess fat, especially around the middle of the body, are likelier to have high blood pressure and elevated blood cholesterol and triglyceride levels, according to the AHA.
- Stress. Some angina attacks are triggered by emotional or physical stress.
- Inactivity. Inactivity is a risk factor for heart disease and angina, most especially when it contributes to obesity.
- Overexertion. As a result of the narrowing, blood flow through the artery isn’t sufficient to meet the heart’s higher demand for oxygen (carried in blood) during exercise, which is why angina typically occurs during physical exertion.
- Smoking. Not only is tobacco smoke (especially cigarette smoke) a risk factor on its own for coronary heart disease, but it works in tandem with other risk factors you may have to dangerously multiply your risk. If you are a nonsmoker, but are often exposed to second-hand smoke, your risk is increased as well.
- Anemia. If you have anemia, you have a lower blood cell count, which means there’s a lower oxygen supply to the heart. Your heart has to work harder to get its required supply of oxygen. This cause of angina could exist without there necessarily being coronary artery disease.
Conventional medicine treats angina with drugs like nitroglycerin, nitrites, nitrates. These relax and widen arteries so that more blood can flow to the heart. Other medications commonly prescribed are beta-blockers and calcium-channel blockers that reduce the workload of the heart. However, these deplete magnesium, which is why many people have heart problems in the first place! Although these drugs can relieve the symptoms, they don’t address the underlying cause of heart disease. All of these medications can also cause serious side effects.
If hard science and patient benefit were central factors in determining the treatment of heart disease, these conventional procedures would be a rarity. But invasive cardiology has nothing to do with science. It has nothing to do with saving lives or improving quality of life. It has to do with money. These procedures generate more than $120 billion a year, a windfall that makes up approximately 45 percent of the total revenue of most hospitals! That’s why angioplasty and bypass remain popular, despite dozens of studies – not one of them showing that either of these procedures prevents heart attacks or premature death for the overwhelming majority of people. Even if you get one of these procedures, half of the patients are clogging up their ‘new or improved’ vessels within six months of the operation. They may relieve angina, but the do not stop the progression of heart disease.
The following medical treatments and procedures are likely to be recommended by your cardiologist:
- Angioplasty. This is done to open blocked or narrowed coronary arteries, improve blood flow and relieve angina. It may include installation of a stent (a small mesh tube) to keep the artery open after the procedure. According to findings from the COURAGE trial—the definitive study on elective angioplasty— eight of 10 patients who undergo this procedure are inappropriate candidates who would be better served by more conservative therapy. Even when the angioplasty procedure is performed without problems, the artery can narrow again months afterward. For instance, my father has this procedure done, but it did not hold and needed to be redone. It ultimately did nothing for his heart health. Narrowing of the artery post-angioplasty can be caused by blood clots occurring at or near the site of the treatment. Aspirin, heparin, coumadin, warfarin or combinations of anti-clotting drugs are generally used before and after the procedures to try and prevent this. Warfarin and coumadin were originally and still are used as rat poison. Oh, but it thins your blood so you should take it if you have heart problems.
- Coronary artery bypass grafting. A surgical procedure that involves taking blood vessels from other areas of your body to “bypass” narrowed areas of coronary arteries in order to improve blood flow to the heart, relieve chest pain and, possibly, prevent a heart attack. This same procedure may be used to bypass narrowed or blocked arteries in the leg. This surgery is invasive and unnecessary. Simple dietary and lifestyle measures can completely reverse blocked arteries. My grandfather and uncle both had this procedure. It involved months of recovery with both speaking of never feeling the same again. The both entered into a slow, steady decline following the surgery. Studies show that you’re more than twice as likely to die from this surgery as you are from heart disease.
- Carotid endarterectomy. Surgery to remove built-up plaque from the carotid arteries in order to restore blood flow to the brain in an effort to prevent a stroke. This surgery can result in bleeding, infection, blood clots, brain damage, stroke or heart attack.
- Aspirin. Fire your doctor, if he recommends taking aspirin to prevent heart attack. High cholesterol and heart disease is not caused by a deficiency of aspirin. Two decades ago it was shown in the Journal of the American Medical Association that aspirin provides no protective benefit. Eight other studies have shown aspirin more than doubles your chance of having a stroke. Aspirin also promotes age related macular degeneration (AMD), the leading cause of blindness in seniors. So, why is this treatment recommended? A 1992 Lancet study funded by the Bayer Corporation (oh, the maker of aspirin!) concluded that aspirin reduced the risk of heart attack. The reason this study showed such great results is because Bayer provided the study with Bufferin, which contains magnesium oxide. Magnesium deficiency is rampant in our society, contributing to all kinds of health problems, including heart disease. It was actually the magnesium, rather than the aspirin, that showed such promising results.
- Low Cholesterol diet. As soon as high cholesterol is diagnosed, you’re told by your doctor to go on a low cholesterol diet. Eeeeh. Wrong. This is dangerous advice. Without sufficient cholesterol, we cannot make our hormones or the membranes of our brain, heart, and other cells. Our brain is 25% cholesterol. It needs cholesterol to function. Without sufficient dietary cholesterol, you are more vulnerable to heart disease, cancer, and Alzheimer’s. This is useless advice because the liver can make three times as much cholesterol in a day as you could eat. It makes 80% of our cholesterol regardless of dietary intake of cholesterol. The dietary staple shown to increase cholesterol is sugar, flour, and refined grains. Learn more about the actual causes of high cholesterol in the Jimmy Moore Cholesterol Clarity Podcast.
Wendy’s Natural Recommendations
Lifestyle changes can help reverse the coronary artery insufficiency that leads to angina. There are so many things you can do to slow or reverse the atherosclerosis that underlies angina.
- Exercise. Regular exercise helps maintain the health of the vessels leading to the heart. Exercise also can strengthen the heart muscle itself.
- Relax after you eat. Some attacks are triggered by exertion after a meal.
- Stop smoking and avoid secondhand smoke. The nicotine from tobacco use can directly affect blood vessels and bring on angina. Smoking oxidizes cholesterol, causing it to deposit in your blood vessels and contribute to atherosclerosis. This is the single most important change you can make to reduce your risk of heart disease and reduce angina. A great program is 14andout.com.
- Control your blood pressure. While I don’t recommend controlling blood pressure by taking blood pressure medication, I do recommend all the suggestions in the brilliant book The Blood Pressure Hoax by Sherry Rogers.
- Relaxation techniques. Some attacks are triggered by emotional or physical stress. It is important to learn relaxation techniques like deep breathing, yoga, and meditation.
- Control cholesterol. The standard tests for cholesterol are outdated. The standard cutoff for high cholesterol is 200, but healthy levels are different for many people. You don’t want your cholesterol levels too low either. Low cholesterol levels below 150 are associated with premature death and many, many health problems. The body needs some cholesterol. You want to look at the size of your cholesterol particles, not just the total cholesterol number. Most doctors do not look at this parameter, even though it is the only meaningful way to evaluate cholesterol numbers. You can have LDL cholesterol that looks normal, say 100, but you may have over 1,000 small LDL particles which are very dangerous. On the other hand, you can have the same LDL number of 100, and it may be made up of 400 large particles which cause no real health risk. HDL cholesterol is very protective – it cleans up oxidized LDL. LDL cholesterol is the culprit causing hardened and blocked arteries. It’s fine as long as it’s not oxidized, but it becomes oxidized with smoking, lack of physical activity, stress, industrial chemicals and a toxic diet.
- Control diabetes. High blood sugar contributes to hardening of the arteries. Note that current research shows that statins (cholesterol-lowering medications) may, in fact, contribute to diabetes. I beg you to reconsider when your doctor advises you to take toxic medications like statins or insulin. You’ll be taking meds to control your high cholesterol, which cause diabetes, which in turn cause hardening of the arteries! Medications make people sicker quicker. Diabetes can be reversed if caught early enough.
- Maintain good dental health. In a new study published in the British Medical Journal researchers found that people with poor oral hygiene had a 70 percent increased likelihood of developing heart disease compared to those who brushed regularly. Because gum disease can cause atherosclerosis, it is vital to brush your teeth at least twice a day and floss daily. Flossing breaks up bacteria colonies in the gums that can get into the blood stream and cause infection and inflammation in other parts of your body. Most importantly, be sure to have regular dental checkups and get your teeth cleaned every six months to remove plaque buildup. If this is not removed, you are very likely to get periodontal disease, which contributes to heart disease.
I recommend purchasing supplements from a website like Pureformulas.com that sells only the highest quality supplements.
- L-carnitine. 1,000 mg twice a day. L-carnitine can help relieve angina symptoms by improving heart muscle metabolism.
- Magnesium. 400–1,000 mg daily. This mineral relaxes the smooth muscle tissues that dilate the arteries and reduce blood pressure. Heart medications and blood pressure medications cause magnesium deficiencies, making you sicker. Magnesium, as with any mineral, should only be taken in chelated form. Large amounts of magnesium can cause diarrhea so build up your dose gradually. Always take chelated magnesium. An amazing array of chelated magnesium supplements, which are better absorbed, can be found in the Myers Detox store.
- Multivitamin. You need to take targeted supplements for heart health, but one also need an overall multivitamin that does not contain copper or iron. I like this Liposomal Ultra Vitamin.
- Fish oil. 2–8 g daily. EPA and DHA, fish oil’s primary omega-3 fatty acids , reduce inflammation, lower blood lipids (especially triglycerides), improve blood viscosity, and normalize heart rhythms. Taking these supplements can reduce cardiovascular mortality by as much as 45 percent. Reduce the suggested dosage if you eat fish three times per week. My favorite fish oil is Super Omega-3 Fish Oil by Life Extension.
- Coenzyme Q10 (CoQ10). 200–600 mg daily. This powerful antioxidant can benefit heart health by influencing the mitochondria, the tiny powerhouses found in heart cells and in cells throughout the body, which is where energy metabolism occurs. In this way, CoQ10 may help lower the heart’s oxygen demands by improving its energy efficiency. It may also help lower blood pressure. This antioxidant helps protect LDL (“bad”) cholesterol from oxidation, maintain healthy blood vessels, lower blood pressure, and can support optimal functioning of the heart muscle. You MUST take this if you have ever been or are currently on statins (high cholesterol medication). If you doctor did not recommend this supplement when prescribing statins, he is acting irresponsibly and shows a lack of scientific knowledge of the drug he is prescribing. When you go on statins, it prevents your liver from producing protective cholesterol and CoQ10, which you need to protect your arteries from further damage. I like Integrative Therapeutic’s UBHQ CoQ10. Their other CoQ10 supplements are good, too. I also like Quicksilver Scientific’s One Mitochondrial Optimizer with CoQ10.
- L-Arginine. 1g, 3 times daily. Arginine is an amino acid that is the precursor to nitric oxide, which is a primary regulator of blood pressure. You must control your blood pressure to reduce or prevent angina pain. Nitric oxide signals the smooth muscle cells of the arteries to relax. This increases their diameter and allows blood to flow more freely with less pressure against arterial walls, thus lowering blood pressure. The recommended starting dose of arginine is one gram three times a day, although some people require double that dose to notice benefits, and doses up to 20 grams are sometimes used. An easier option is time-release arginine.
- R-Lipoic Acid. Take 300mg of R-Lipoic Acid daily. In a recent study at the Emory University School of Medicine, Atlanta, researchers reported that 300 mg of R-lipoic acid improved endothelial function by almost 50 percent, and the antioxidant also enhanced the benefits of a drug used to treat heart disease. I prefer R-lipoic acid to the more popular alpha-lipoic acid because R-lipoic acid is all natural, making it more effective, while alpha-lipoic acid is a combination of natural and synthetic lipoic acid. Life Extension has a great lipoic acid.
- Plant Sterols. 1,800 to 2,600 mg daily.Sterols (also called phytosterols) are natural fatty substances found in all plants. Similar in structure to cholesterol, plant sterols and stanols (saturated sterols) have unique health benefits—and none of cholesterol’s negative effects. In one study, published in the New England Journal of Medicine, daily intake of 1,800 to 2,600 mg of sterols decreased total cholesterol by 10.2 percent and LDL cholesterol by 14.1 percent.
- Hawthorne (Crataegus oxycantha). Staring dose is 500 mg daily. This herbal preparation made from the leaves and flowers of a species of hawthorn tree may help relieve angina symptoms by increasing coronary artery blood flow. Hawthorne should only be used under the supervision of a physician.
- Follow a low-glycemic diet. You must remove sugar, flour, and refined grains from your diet. Ideally, ALL grains, including whole grains, should be removed. The consumption of these foods raises blood sugar, which damages blood vessels. Consequently, your liver produces cholesterol to go in and repair the damage caused by these foods. This is one of the main causes of arterial blockage that leads to angina pain.
- Follow an anti-inflammatory diet. The Modern Paleo Diet is the perfect diet to reduce inflammation, a major cause of hardening and blockage of the arteries that lead to angina. It is also low-glycemic.
- Omega-3. Atherosclerosis is associated with a deficiency in omega-3 fatty acids. Eat more oily fish, fish oil supplements, walnuts, macadamia nuts, and flaxseed. Grass fed, organic meats have significantly more omega-3 than conventionally raised factory-farmed meats. Factory-farmed meats are very high in omega-6, which block the absorption of omega-3 even if you eat sufficient quantities and take fish oil. I carry a great EPA DHA.
- Garlic. Long revered for its health benefits, garlic is rich in antioxidants and increases nitric oxide production. In a study of 15 men with coronary heart disease, researchers found that 2.4 grams of aged garlic extract reduced endothelial dysfunction by 44 percent. You can eat either raw garlic, aged (fermented) garlic, or take Kyolic aged garlic extract.
- Flaxseed. Mix a quarter cup of ground flaxseed in juice and drank it once a day, an hour before your main meal. Flaxseed is an excellent source of fiber. Soluble fiber binds to bile acids in the intestinal tract and interferes with the reabsorption of cholesterol into the bloodstream. In addition, flaxseed is nature’s richest plant source of protective omega-3 essential fatty acids (EFAs). Because the oils in ground flaxseed can quickly become rancid, I recommend using whole flaxseed, rather than pre-ground seeds. Whole flaxseeds are extremely shelf-stable and can be stored for years. Organic golden flax seeds are the best. These tiny golden or brown seeds have a rich, nutty flavor and can be sprinkled on cereal and salads or mixed in water or a protein drink (stir and drink quickly, as it thickens as it sits). Simply grind them in a food mill or coffee grinder before serving. Ground flax seeds can be kept fresh in the fridge for two months.
- Avoid Trans Fats. These deadly fats raise cholesterol levels and contribute to heart disease more than any other food. They are in almost all processed foods and ALL fast foods. If trans fats were eliminated from the food supply, heart disease would be reduced by 50%! Avoid any foods with partially hydrogenated oils or interesterified fats on the ingredient label.
- Avoid Fried Foods and Vegetable Oils. Research on endothelial function has clearly shown that eating deep-fried foods can have a disastrous effect on your blood vessel tone. Vegetable oils are touted as healthy by the food industry because they are so profitable, but they are actually highly inflammatory. The only exception is healthy olive oil.
- Avoid Wheat. Wheat is known to cause inflammation and other health problems in most people, not just those with gluten sensitivity. There are typically no symptoms, unless you are gluten intolerant. Gluten is the protein in wheat. Repeated exposure to wheat accelerates glycation (a type of chemical reaction that happens when sugar molecules attack proteins or lipid fats) in the lining of your arteries, contributing to hardening. Read more about why wheat is bad for you in Wheat Belly by William Davis, MD. For more information, you can also read my blog Gluten Sensitivity Affects 1 in 3.
- Avoid Sugar. Blood sugar must be controlled in order to stop and reverse the onset of heart disease and angina. This means avoiding sugar and anything else that will raise blood sugar, like most refined grains. Sugar acts like shards of glass in the arteries. It cuts the insides of the arteries, causing scar tissue. This scar tissue builds up and hardens the arteries and causes blockages which lead to angina pain. Sugar and other refined carbohydrates elevate insulin levels. Increased insulin levels are associated with increased cholesterol, triglycerides, blood pressure, and death from cardiovascular disease.
- Myers Detox with Hair Mineral Analysis. This program uses a hair mineral analysis to test for mineral levels and heavy metals, allowing you to do targeted remineralization of your body – imperative for your health and detoxification. The underlying cause of most disease and health conditions are chemical and heavy metal toxicity. Angina will no doubt be helped by eliminating heavy metals and industrial chemicals, built up in your system over your lifetime that are aggravating or causing this condition. In the process, you will greatly increase your overall health and prevent future diseases from developing. I offer extensive information on this site on how to detox from heavy metals and chemicals.
- Infrared Saunas. Infrared Saunas are imperative to sweat out the hundreds of industrial chemicals we ingest every day. These chemicals not only contribute to hardening of the arteries, but so many other diseases and health conditions. Read more about them in my article Infrared Saunas.
- Enhanced External Counterpulsation. EECP is a nonsurgical therapy with incredible benefits for the cardiovascular system. It stimulates the formation of collateral circulation, or new blood vessels around clogged arteries. This is like a natural heart bypass! It’s much cheaper than open heart surgery, which will run you $100,000. EECP can be performed every day for 30-45 days at $200 a session. The overwhelming majority of people who do this therapy do not end up having to undergo bypass surgery.
- Hyperbaric Oxygen Therapy. Hyperbaric oxygen therapy (HBOT) restores blood flow and helps build collateral circulation. HBOT forces oxygen into your cells, oxygenating your tissues and clearing out toxins.
- Hippocrates Health Institute. If you need serious intervention to improve your health look no further than the Hippocrates Health Institute. This amazing institution has rejuvenated patients, very much alive today, after their doctor told them there was nothing more to be done and to go home to die.
- The Whittaker Wellness Institute. Whittaker Wellness Institute in Newport Beach, Ca is one of the largest alternative medical centers in the US. Want to truly cure your angina? Go here instead of your conventional doctor.