Table of ContentsView AllTable of ContentsWhat Is Angina?Lifestyle ChoicesEmotional HealthComplementary TherapiesHow to Treat an Attack
Table of ContentsView All
View All
Table of Contents
What Is Angina?
Lifestyle Choices
Emotional Health
Complementary Therapies
How to Treat an Attack
Anginais chest pain that happens when your heart isn’t receiving enough oxygen-rich blood. The condition can be treated with prescription drugs and medical procedures likeangioplasty, but a major part of treatment is making healthy lifestyle choices. Complimentary therapies can be part of the treatment plan. Discuss these with a healthcare provider to make an informed choice.
The article describes the symptoms and possible complications of angina and offers guidance on managing the condition with self-care and natural treatments.
Neil Holmes / Photolibrary / Getty Images
Symptoms of angina include:
Possible Complications
Left untreated, stable angina can worsen and develop into unstable angina, typically in tandem with the progression ofatherosclerosis(hardening of the arteries).
This, in turn, can lead to potentially life-threatening complications, such as:
Lifestyle Changes for Managing Angina
Angina is often managed with medications likebeta-blockersandcalcium channel blockersand medical procedures likeballoon angiography. Lifestyle also plays a central role in the management of angina as it does with any form of heart disease.
There are four key components to any angina self-care strategy:
Eat a Healthy Diet
People with heart disease or at risk of heart disease are advised to eat a diet low in saturated fat and refined carbohydrates and high in fruits, vegetables, and whole grains. There is also a direct correlation between the risk of angina and certain dietary interventions.
If you have been diagnosed with angina, there are some dietary changes you can make to reduce your risk of an attack:
Exercise
Exercise has many benefits to heart health. It can promote the clearance of “bad” cholesterol from the blood, reduce blood pressure, and lower the risk of fatty plaque build-up in arteries.
With respect to angina, exercise may not entirely eliminate it, but there is evidence that it can reduce the frequency of attacks and possibly eliminate the need for beta-blockers in some people.
Studies have shown that exercise can be performed safely in most people with angina, using a 5- to 10-minute warm-up to prepare the heart for a moderate-intensity workout.
Guidelines recommend at least 30 minutes ofaerobic exerciseperformed at least five days a week. An aerobic activity is moderate-intensity aerobic if you can talk but not sing while doing it.
Examples include:
For people with frequent angina, lower-body activities like cycling are less likely to trigger angina than upper-body activities like rowing.
Maintain a Healthy Weight
There is a direct association betweenvisceral adiposity(the fat around your abdominal organs) and the risk of angina.
Studies have shown that people in the upper tertile of visceral adiposity (meaning those with the most visceral fat) are nearly three times more likely to experience angina than those in the lower tertile (meaning those with the least visceral fat).
While visceral adiposity can be a feature of obesity—defined as abody mass index (BMI)greater than 35—it can occur independently of obesity. At the upper end of the scale, however, the likelihood of obesity is high.
To this end, the reduction of excess visceral fat will almost invariably involve a weight loss program with diet and exercise.
Obesity is not the only concern. Being underweight (defined as a BMI of less than 18.5 ) is associated with a 23% greater risk of angina compared to people of normal weight. Normalizing your weight may reduce the risk of angina and other complications of coronary artery disease.
How to Lose Weight Safely
Get Quality Sleep
Poor sleep quality and sleep deprivation are associated with a higher risk of angina.
Some studies have shown that even moderate sleep loss can double your risk of angina, daytime compared to people who get therecommended amount of sleepeach night.
Quit Smoking
Improving Emotional Health to Manage Angina
Stress and the release of the stress hormone cortisol are major factors linked to the frequency and severity of angina. Studies have long shown a strong association between emotional distress and angina, independent of weight, age, sex, smoking, or any other risk factor.
A 2019 study inPLoS Onereported that people with CAD who exhibit the five characteristics of psychological distress—anxiety, hostility, depression, feelings of inferiority, and poor sleep—have a nearly three-fold greater risk of angina compared to those without psychological distress.
This emphasizes the need for good mental health, along with good physical health, to manage angina over the long term.
The American Heart Association recommends six self-help measures to manage stress and improve your quality of life if you have coronary artery disease:
If you find that you cannot overcome feelings of anxiety or depression, do not hesitate to ask your healthcare provider for a referral to atherapist or psychiatristwho can help.
Alternative Therapies to Manage Angina
Complementary therapies are increasingly used to manage CAD and angina. To date, the evidence supporting the benefits remains slim, but there are promising signs.
Natural therapies that may be of help include:
Self-Care During an Angina Attack
Even with the best interventions, angina attacks can sometimes occur and require the appropriate treatment to bring it under control.
If you have an angina attack:
You can also use nitroglycerin to avoid an attack before exercise. Speak with your cardiologist to ensure this is OK. Symptoms include headache, flushing, or dizziness soon after taking the dose.
Summary
In addition to medications and balloon angiography, a healthy lifestyle can help manage angina and prevent attacks. This includes eating a heart-healthy diet, exercising regularly, maintaining a healthy weight, getting plenty of sleep, quitting cigarettes, and managing stress.
18 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Heart Association.Angina (chest pain).Gulati M, Levy PD, Mukherjee D, et al.2021. AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR guideline for the evaluation and diagnosis of chest pain: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.Circulation. 2021;144(22):e368-e454. doi:10.1161/CIR.0000000000001029Van Parys A, Saele J, Puaschitz NG, et al.The association between dairy intake and risk of cardiovascular disease and mortality in patients with stable angina pectoris.Eur J Prev Cardiol.2023 Feb 14;30(3):219-229. doi:10.1093/eurjpc/zwac217Matre AO, Van Parys A, Olsen T, et al.The association of meat intake with all-cause mortality and acute myocardial infarction is age-dependent in patients With stable angina pectoris.Front Nutr.2021;8:642612. doi:10.3389/fnut.2021.642612Massera D, Graf L, Barba S, Ostfeld R.Angina rapidly improved with a plant-based diet and returned after resuming a Western diet.J Geriatr Cardiol.2016 May;13(4):364–366. doi:10.11909/j.issn.1671-5411.2016.04.005Ralf Dechend, Hans-Georg Predel.Exercise in patients with chronic angina pectoris: friend or foe?Cardiol Cardiovasc Med.2022;6:364-373.Centers for Disease Control and Prevention.Adult activity: An overview. June 2, 2022.Zhang Y, He Q, Zhang W, et al.Non-linear associations between visceral adiposity index and cardiovascular and cerebrovascular diseases: results from the NHANES (1999–2018).Front Cardiovasc Med.2022;9:908020. doi:10.3389/fcvm.2022.908020Park D, Lee JH, Han S.Underweight: another risk factor for cardiovascular disease? A cross-sectional 2013 Behavioral Risk Factor Surveillance System (BRFSS) study of 491,773 individuals in the USA.Medicine (Baltimore).2017 Dec;96(48):e8769. doi:10.1097/MD.0000000000008769Sircu V, Colesnic SI, Covantsev S, et al.The burden of comorbidities in obstructive sleep apnea and the pathophysiologic mechanisms and effects of CPAP.Clocks Sleep.2023 Jun;5(2):333–349. doi:10.3390/clockssleep5020025Liu J, Zhu Y, Chang Y, et al.Association of objective sleep characteristics and incident angina pectoris: a longitudinal analysis from the Sleep Heart Health Study.Nat Sci Sleep.2023;15:955–965. doi:10.2147/NSS.S429231Buchanan DM, Arnold SV, Gosch KL, et al.The association of smoking status with angina and health-related quality of life after acute myocardial infarction.Circ Cardiovasc Qual Outcomes.2015 Sep;8(5):493–500. doi:10.1161/CIRCOUTCOMES.114.001545Tsai CC, Chuang SY, Hsieh IC, Ho LH, Chu PH.The association between psychological distress and angina pectoris: a population-based study.PLoS One.2019;14(11):e0224451. doi:10.1371/journal.pone.0224451American Heart Association.Stress and heart health.Wang J, Xiong X, Feng B.Effect of crataegus usage in cardiovascular disease prevention: an evidence-based approach.Evid Based Complement Alternat Med. 2013;2013:149363. doi:10.1155/2013/149363Zhao JV, Burgess S, Fan B, Schooing CM.L-carnitine, a friend or foe for cardiovascular disease? A Mendelian randomization study.BMC Med.2022;20:272. doi:10.1186/s12916-022-02477-zLi J, Gao X, Hao X, et al.Yoga for secondary prevention of coronary heart disease: A systematic review and meta-analysis.Complement Ther Med. 2021;57:102643. doi:10.1016/j.ctim.2020.102643National Health Service (UK).Treatment: angina. April 24, 2024.
18 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Heart Association.Angina (chest pain).Gulati M, Levy PD, Mukherjee D, et al.2021. AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR guideline for the evaluation and diagnosis of chest pain: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.Circulation. 2021;144(22):e368-e454. doi:10.1161/CIR.0000000000001029Van Parys A, Saele J, Puaschitz NG, et al.The association between dairy intake and risk of cardiovascular disease and mortality in patients with stable angina pectoris.Eur J Prev Cardiol.2023 Feb 14;30(3):219-229. doi:10.1093/eurjpc/zwac217Matre AO, Van Parys A, Olsen T, et al.The association of meat intake with all-cause mortality and acute myocardial infarction is age-dependent in patients With stable angina pectoris.Front Nutr.2021;8:642612. doi:10.3389/fnut.2021.642612Massera D, Graf L, Barba S, Ostfeld R.Angina rapidly improved with a plant-based diet and returned after resuming a Western diet.J Geriatr Cardiol.2016 May;13(4):364–366. doi:10.11909/j.issn.1671-5411.2016.04.005Ralf Dechend, Hans-Georg Predel.Exercise in patients with chronic angina pectoris: friend or foe?Cardiol Cardiovasc Med.2022;6:364-373.Centers for Disease Control and Prevention.Adult activity: An overview. June 2, 2022.Zhang Y, He Q, Zhang W, et al.Non-linear associations between visceral adiposity index and cardiovascular and cerebrovascular diseases: results from the NHANES (1999–2018).Front Cardiovasc Med.2022;9:908020. doi:10.3389/fcvm.2022.908020Park D, Lee JH, Han S.Underweight: another risk factor for cardiovascular disease? A cross-sectional 2013 Behavioral Risk Factor Surveillance System (BRFSS) study of 491,773 individuals in the USA.Medicine (Baltimore).2017 Dec;96(48):e8769. doi:10.1097/MD.0000000000008769Sircu V, Colesnic SI, Covantsev S, et al.The burden of comorbidities in obstructive sleep apnea and the pathophysiologic mechanisms and effects of CPAP.Clocks Sleep.2023 Jun;5(2):333–349. doi:10.3390/clockssleep5020025Liu J, Zhu Y, Chang Y, et al.Association of objective sleep characteristics and incident angina pectoris: a longitudinal analysis from the Sleep Heart Health Study.Nat Sci Sleep.2023;15:955–965. doi:10.2147/NSS.S429231Buchanan DM, Arnold SV, Gosch KL, et al.The association of smoking status with angina and health-related quality of life after acute myocardial infarction.Circ Cardiovasc Qual Outcomes.2015 Sep;8(5):493–500. doi:10.1161/CIRCOUTCOMES.114.001545Tsai CC, Chuang SY, Hsieh IC, Ho LH, Chu PH.The association between psychological distress and angina pectoris: a population-based study.PLoS One.2019;14(11):e0224451. doi:10.1371/journal.pone.0224451American Heart Association.Stress and heart health.Wang J, Xiong X, Feng B.Effect of crataegus usage in cardiovascular disease prevention: an evidence-based approach.Evid Based Complement Alternat Med. 2013;2013:149363. doi:10.1155/2013/149363Zhao JV, Burgess S, Fan B, Schooing CM.L-carnitine, a friend or foe for cardiovascular disease? A Mendelian randomization study.BMC Med.2022;20:272. doi:10.1186/s12916-022-02477-zLi J, Gao X, Hao X, et al.Yoga for secondary prevention of coronary heart disease: A systematic review and meta-analysis.Complement Ther Med. 2021;57:102643. doi:10.1016/j.ctim.2020.102643National Health Service (UK).Treatment: angina. April 24, 2024.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Heart Association.Angina (chest pain).Gulati M, Levy PD, Mukherjee D, et al.2021. AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR guideline for the evaluation and diagnosis of chest pain: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.Circulation. 2021;144(22):e368-e454. doi:10.1161/CIR.0000000000001029Van Parys A, Saele J, Puaschitz NG, et al.The association between dairy intake and risk of cardiovascular disease and mortality in patients with stable angina pectoris.Eur J Prev Cardiol.2023 Feb 14;30(3):219-229. doi:10.1093/eurjpc/zwac217Matre AO, Van Parys A, Olsen T, et al.The association of meat intake with all-cause mortality and acute myocardial infarction is age-dependent in patients With stable angina pectoris.Front Nutr.2021;8:642612. doi:10.3389/fnut.2021.642612Massera D, Graf L, Barba S, Ostfeld R.Angina rapidly improved with a plant-based diet and returned after resuming a Western diet.J Geriatr Cardiol.2016 May;13(4):364–366. doi:10.11909/j.issn.1671-5411.2016.04.005Ralf Dechend, Hans-Georg Predel.Exercise in patients with chronic angina pectoris: friend or foe?Cardiol Cardiovasc Med.2022;6:364-373.Centers for Disease Control and Prevention.Adult activity: An overview. June 2, 2022.Zhang Y, He Q, Zhang W, et al.Non-linear associations between visceral adiposity index and cardiovascular and cerebrovascular diseases: results from the NHANES (1999–2018).Front Cardiovasc Med.2022;9:908020. doi:10.3389/fcvm.2022.908020Park D, Lee JH, Han S.Underweight: another risk factor for cardiovascular disease? A cross-sectional 2013 Behavioral Risk Factor Surveillance System (BRFSS) study of 491,773 individuals in the USA.Medicine (Baltimore).2017 Dec;96(48):e8769. doi:10.1097/MD.0000000000008769Sircu V, Colesnic SI, Covantsev S, et al.The burden of comorbidities in obstructive sleep apnea and the pathophysiologic mechanisms and effects of CPAP.Clocks Sleep.2023 Jun;5(2):333–349. doi:10.3390/clockssleep5020025Liu J, Zhu Y, Chang Y, et al.Association of objective sleep characteristics and incident angina pectoris: a longitudinal analysis from the Sleep Heart Health Study.Nat Sci Sleep.2023;15:955–965. doi:10.2147/NSS.S429231Buchanan DM, Arnold SV, Gosch KL, et al.The association of smoking status with angina and health-related quality of life after acute myocardial infarction.Circ Cardiovasc Qual Outcomes.2015 Sep;8(5):493–500. doi:10.1161/CIRCOUTCOMES.114.001545Tsai CC, Chuang SY, Hsieh IC, Ho LH, Chu PH.The association between psychological distress and angina pectoris: a population-based study.PLoS One.2019;14(11):e0224451. doi:10.1371/journal.pone.0224451American Heart Association.Stress and heart health.Wang J, Xiong X, Feng B.Effect of crataegus usage in cardiovascular disease prevention: an evidence-based approach.Evid Based Complement Alternat Med. 2013;2013:149363. doi:10.1155/2013/149363Zhao JV, Burgess S, Fan B, Schooing CM.L-carnitine, a friend or foe for cardiovascular disease? A Mendelian randomization study.BMC Med.2022;20:272. doi:10.1186/s12916-022-02477-zLi J, Gao X, Hao X, et al.Yoga for secondary prevention of coronary heart disease: A systematic review and meta-analysis.Complement Ther Med. 2021;57:102643. doi:10.1016/j.ctim.2020.102643National Health Service (UK).Treatment: angina. April 24, 2024.
American Heart Association.Angina (chest pain).
Gulati M, Levy PD, Mukherjee D, et al.2021. AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR guideline for the evaluation and diagnosis of chest pain: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.Circulation. 2021;144(22):e368-e454. doi:10.1161/CIR.0000000000001029
Van Parys A, Saele J, Puaschitz NG, et al.The association between dairy intake and risk of cardiovascular disease and mortality in patients with stable angina pectoris.Eur J Prev Cardiol.2023 Feb 14;30(3):219-229. doi:10.1093/eurjpc/zwac217
Matre AO, Van Parys A, Olsen T, et al.The association of meat intake with all-cause mortality and acute myocardial infarction is age-dependent in patients With stable angina pectoris.Front Nutr.2021;8:642612. doi:10.3389/fnut.2021.642612
Massera D, Graf L, Barba S, Ostfeld R.Angina rapidly improved with a plant-based diet and returned after resuming a Western diet.J Geriatr Cardiol.2016 May;13(4):364–366. doi:10.11909/j.issn.1671-5411.2016.04.005
Ralf Dechend, Hans-Georg Predel.Exercise in patients with chronic angina pectoris: friend or foe?Cardiol Cardiovasc Med.2022;6:364-373.
Centers for Disease Control and Prevention.Adult activity: An overview. June 2, 2022.
Zhang Y, He Q, Zhang W, et al.Non-linear associations between visceral adiposity index and cardiovascular and cerebrovascular diseases: results from the NHANES (1999–2018).Front Cardiovasc Med.2022;9:908020. doi:10.3389/fcvm.2022.908020
Park D, Lee JH, Han S.Underweight: another risk factor for cardiovascular disease? A cross-sectional 2013 Behavioral Risk Factor Surveillance System (BRFSS) study of 491,773 individuals in the USA.Medicine (Baltimore).2017 Dec;96(48):e8769. doi:10.1097/MD.0000000000008769
Sircu V, Colesnic SI, Covantsev S, et al.The burden of comorbidities in obstructive sleep apnea and the pathophysiologic mechanisms and effects of CPAP.Clocks Sleep.2023 Jun;5(2):333–349. doi:10.3390/clockssleep5020025
Liu J, Zhu Y, Chang Y, et al.Association of objective sleep characteristics and incident angina pectoris: a longitudinal analysis from the Sleep Heart Health Study.Nat Sci Sleep.2023;15:955–965. doi:10.2147/NSS.S429231
Buchanan DM, Arnold SV, Gosch KL, et al.The association of smoking status with angina and health-related quality of life after acute myocardial infarction.Circ Cardiovasc Qual Outcomes.2015 Sep;8(5):493–500. doi:10.1161/CIRCOUTCOMES.114.001545
Tsai CC, Chuang SY, Hsieh IC, Ho LH, Chu PH.The association between psychological distress and angina pectoris: a population-based study.PLoS One.2019;14(11):e0224451. doi:10.1371/journal.pone.0224451
American Heart Association.Stress and heart health.
Wang J, Xiong X, Feng B.Effect of crataegus usage in cardiovascular disease prevention: an evidence-based approach.Evid Based Complement Alternat Med. 2013;2013:149363. doi:10.1155/2013/149363
Zhao JV, Burgess S, Fan B, Schooing CM.L-carnitine, a friend or foe for cardiovascular disease? A Mendelian randomization study.BMC Med.2022;20:272. doi:10.1186/s12916-022-02477-z
Li J, Gao X, Hao X, et al.Yoga for secondary prevention of coronary heart disease: A systematic review and meta-analysis.Complement Ther Med. 2021;57:102643. doi:10.1016/j.ctim.2020.102643
National Health Service (UK).Treatment: angina. April 24, 2024.
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