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Risk factors
By Mayo Clinic staffThe following risk factors increase your risk of coronary artery disease and angina:
- Tobacco use. Chewing tobacco, smoking and long-term exposure to secondhand smoke damage the interior walls of arteries — including arteries to your heart — allowing deposits of cholesterol to collect and block blood flow.
- Diabetes. Diabetes is the inability of your body to produce or respond to insulin properly. Insulin, a hormone secreted by your pancreas, allows your body to use glucose, which is a form of sugar from foods. Diabetes greatly increases the risk of coronary artery disease, which leads to angina and heart attacks by speeding up atherosclerosis and increasing your cholesterol levels
- High blood pressure. Blood pressure is determined by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. Over time, high blood pressure damages arteries by accelerating atherosclerosis. High blood pressure can be an inherited problem. The risk of high blood pressure increases as you age, but the main causes are eating a diet too high in salt, stress, inadequate exercise and being overweight.
- High blood cholesterol or triglyceride levels. Cholesterol is a major part of the deposits that can narrow arteries throughout your body, including those that supply your heart. A high level of the wrong kind of cholesterol in your blood increases your risk of angina and heart attacks. Low-density lipoprotein (LDL) cholesterol (the "bad" cholesterol) is most likely to narrow arteries. A high LDL level is undesirable and is often a byproduct of a diet high in saturated fats and cholesterol. A high level of triglycerides, a type of blood fat related to your diet, also is undesirable.
- Personal or family history of heart disease. If you have coronary artery disease or if you've had a heart attack, you're at a greater risk of developing angina.
- Older age. Men older than 45 and women older than 55 have a greater risk than younger adults.
- Lack of exercise. An inactive lifestyle contributes to high blood cholesterol levels and obesity. Exercise is beneficial in lowering high blood pressure. However, it is important to consult with your doctor before starting an exercise program.
- Obesity. Obesity raises the risk of angina and heart disease because it's associated with high blood cholesterol levels, high blood pressure and diabetes. Also, your heart has to work harder to supply blood to the excess tissue.
- Stress. You may respond to stress in ways that can increase your risk of angina and heart attacks. If you're under stress, you may overeat or smoke from nervous tension. Too much stress, as well as anger, can also raise your blood pressure. Surges of hormones produced during stress can narrow your arteries and worsen angina.
References
- Angina. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/Angina/Angina_All.html. Accessed March 14, 2011.
- Angina pectoris. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=4472. Accessed March 14, 2011.
- ACC/AHA management of patients with unstable angina/non-ST-elevation myocardial infarction — Pocket guideline. American College of Cardiology and the American Heart Association. http://www.americanheart.org/downloadable/heart/1194979355638UA-NSTEMI.Text.Final.pdf. Accessed March 14, 2011.
- Patient information sheet: Ranolazine. U.S. Food and Drug Administration. http://www.fda.gov/Cder/drug/InfoSheets/patient/ranolazine.pdf. Accessed March 14, 2011.
- L-arginine. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed March 11, 2011.
- Ruel M, et al. Concomitant treatment with oral L-arginine improves the efficacy of surgical angiogenesis in patients with severe diffuse coronary artery disease: The endothelial modulation in angiogenic therapy randomized controlled trial. Journal of Thoracic and Cardiovascular Surgery. 2008;135:762.
- L-carnitine. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed March 11, 2011.
- Ferrari R, et al. Therapeutic effects of l-carnitine and propionyl-l-carnitine on cardiovascular diseases: A review. Annals of the New York Academy of Sciences. 2004;1033:79.
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