Reducing Your Risk of Coronary Artery Disease (CAD) and Angina
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Reducing Your Risk of Coronary Artery Disease (CAD) and Angina

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You can reduce your risk of angina and CAD by making certain lifestyle changes. These include:

Lose Excess Weight

Excess weight puts a strain on the heart muscle, which eventually can lead to angina and CAD. If you are overweight or obese , adopt a sensible eating plan and exercise regularly to lose weight gradually, and maintain your weight at the desired level.

Discontinue or Avoid Smoking

Smoking damages your blood vessels, reduces the amount of oxygen in your blood, and forces your heart to work harder. Discuss with your doctor the best way to help you quit smoking .

Limit Alcohol Intake

Alcohol should be limited to no more then 1 to 2 ounces a day. In this quantity, alcohol may have a beneficial effect on raising your good cholesterol (HDL).

Limit Fat and Cholesterol

Diets that are high in saturated fat, trans fat, and cholesterol increase your risk of CAD. Saturated fat and cholesterol are found in animal products, most dairy products (such as milk, cream, and cheese), lard, and palm and coconut oils, among other foods. Trans fat is found in margarine and vegetable shortening, as well as foods containing these products. A registered dietitian can help you reduce saturated fats and cholesterol in your diet. Good dietary choices include fresh fruits and vegetable, as well as lean meats and fish—particularly fish rich in omega-3 fatty acids such as salmon.

Even if you currently have no known coronary heart disease (CHD), you may benefit from taking statin (cholesterol-lowering) medications, particularly if your cholesterol levels are elevated. In a recent review of seven clinical trials, subjects without known CHD who took statins for at least one year had a significant decrease in CHD events (eg, heart attack ) and cerebrovascular disease event (eg, strokes ) and procedures to treat coronary heart disease (eg, bypass surgery). However, taking statins did not affect mortality from CHD or any other cause. *

Control Blood Glucose Levels If You have Diabetes

People who have diabetes may reduce their risk of heart attack or other cardiac events if they maintain their blood glucose near normal levels. There are many other proven health benefits to maintaining tight control of blood glucose. If you have diabetes, talk to your doctor about ways to manage your blood sugar.

Keep Homocysteine Levels Low

Homocysteine is an amino acid found naturally in the body; high levels in the blood are linked to CAD. Currently, scientists are not sure whether homocysteine is a cause of CAD, or just a marker. However, homocysteine levels may be reduced by an increased intake of vitamin B6 , vitamin B12 , and folic acid .

Maintain Normal Blood Pressure

High blood pressure (hypertension) is one of the most critical risk factors for angina and coronary artery disease. Hypertension causes the heart muscles to work harder; the increased strain on the heart can lead to heart failure. Discuss with your doctor the best way to reach and maintain a healthy blood pressure, which involves diet, weight and exercise controls, and possibly medication.

Exercise Regularly

For people who have not yet developed CAD, regular aerobic exercise, such as brisk walking or using a stationary bike or treadmill, is recommended. Exercise will strengthen the heart muscle and can help lower blood pressure. Exercise is recommended in moderation (at least 3-4 times a week for 30 minutes). However, if you already have CAD, talk to your doctor before starting any new exercise program.

Learn to Conquer Stress

Emotional stress may bring on anginal pain. Think about what you can do in your life to cut down on stressful activities and situations. Consider learning meditation, progressive relaxation, or other techniques that you can use when you feel stressed. Try to work in an afternoon nap, since rest seems to be protective against both angina and stress.

When to Contact Your Healthcare Provider

There are some common warning signs that may signal angina and CAD. Contact your healthcare provider if you notice any of these symptoms:

  • Chest pain
  • Shortness of breath out of proportion to exercise or exertion
  • Increased fatigue


American Dietetic Association website. Available at: .

American Heart Association website. Available at: .

Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 7th ed. WB Saunders; 2005.

The Homocysteine Studies Collaboration. Homocysteine and risk of ischemic heart disease and stroke: a meta-analysis. JAMA. 2002;288:2015-2022.

Wilson, PWF. Homocysteine and coronary heart disease. How great is the hazard? JAMA. 2002;288:2042-2043.

* Updated Limit Fat and Cholesterol section on 12/21/2006 according to the following study, as cited by DynaMed's Systematic Literature Surveillance : Thavendiranathan P, Bagai A, Brookhart MA, Choudhry NK. Primary prevention of cardiovascular diseases with statin therapy: a meta-analysis of randomized controlled trials. Arch Intern Med. 2006;166:2307-2313.

Last reviewed May 2007 by Craig Clark, DO, FACC, FAHA, FASE

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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