Does having angina put you at risk for a heart attack? What’s the difference between stable and unstable angina? Johns Hopkins cardiologist Ravi Ranjan answers patients’ questions.
Q. I was recently diagnosed with angina. I am a 67-year-old woman, and other than being about 30 pounds overweight, I’ve been in good health my whole life. Is there a link between angina and heart attack, and, if so, what can I do to forestall a heart attack?
From a Heart Bulletin subscriber in Olympia, Washington
A. The onset of angina is indicative of obstructive coronary artery disease, which can lead to a heart attack. To help prevent a heart attack, you can modify your risk factors by losing weight, starting an exercise regimen if you don’t already engage in regular physical activity, and eating more healthfully.
A heart healthy diet includes lots of fruits and vegetables, a moderate amount of whole grains, legumes, nuts, and oily fish, and small amounts of lean meat, poultry, and lowfat dairy foods.
In order to lose weight, you’ll also need to watch your portion sizes. I use this trick to help my patients: Visualize a normal-size dinner plate divided into four equal sections. Fill half the plate (two sections) with fruits and/or vegetables; fill a quarter of the plate with whole grains (rice, pasta, or bread); and fill the remaining quarter with lean meat, poultry, or fish. This trick will keep you mindful of portion sizes without becoming a slave to calorie counting.
Other heart attack risk factors are high cholesterol and high blood pressure. Your physician can determine if you have either of these, and if you do, whether you’ll need medication to lower them.
Q. My doctor just diagnosed me with unstable angina. I am 73 years old and had chest pains over the course of three months before I was finally diagnosed. My younger brother has stable angina and says he is less at risk for a heart attack than I am. What are the differences between stable and unstable angina, and is my brother really at lower risk? Is there anything can I do to lower my own risk?
From a Heart Bulletin subscriber in Gibson Island, Maryland
A. Stable angina usually refers to chest discomfort associated with physical activity or emotional stress that is relieved by rest and/or nitroglycerin within 5 to 15 minutes. Unstable angina usually refers to chest pain that occurs at rest or with minimal activity, usually severe and of recent onset (within one month), or getting more severe and/or frequent.
Both you and your brother are at risk, but unstable angina can be an indication of progressive coronary disease. You can modify the risk factors by lowering your cholesterol, controlling hypertension, exercising regularly, eating a healthful diet, stopping smoking if you smoke, and controlling your weight. Also, if you don’t already take a daily aspirin, speak with your doctor about doing so.
