Angina is a common medical condition which affects older people. According to the NHS, it’s estimated that one in every 12 men and one in every 30 woman between 55 and 64 years of age have the condition.
As you can tell by these statistics, Angina is more common in men than women. The figures rise for those aged 65 and over:
One in every seven men and one in every 12 women who are aged 65 and over have Angina” – NHS Choices
You may have seen our in-depth guide to the medical conditions which affect older people. Today’s article focuses on angina, as we look at the symptoms, treatments and possible causes of the condition.
What is Angina?
The British Heart Foundation (BHF) define angina as being a pain or discomfort felt in your chest, usually caused by coronary heart disease. You will feel pain due to the blood supply to your heart’s muscles being restricted. It is likely that this is happening due to the arteries supplying the heart becoming hardened and narrow.
This is medically known as atherosclerosis. Your arteries harden and narrow due to a build-up of substances known as plaques. This restricts the blood flow to the heart and therefore triggers the symptoms of angina.
Typically, angina pain is triggered by physical activity or stress. In most cases you will feel pain for a few minutes. These periods of pain are commonly known as angina attacks. There are two different types of angina for you to look out for:
- Stable Angina – This is when an attack has been triggered by an obvious trigger such as exercising. This type of angina can be improved with medication and enough rest.
- Unstable Angina – This is when an attack is unpredictable, occurring with no obvious trigger even when you rest.
Although stable angina is not considered life threatening, it should be seen as a serious warning sign that you could be at risk of a life-threatening heart attack or a stroke. It’s estimated that one in every 100 people with stable angina will have a fatal heart attack or stroke each year.
Unstable angina on the other hand should be taken as a medical emergency. It is a sign that the function of your heart as suddenly and rapidly deteriorated.
During an angina attack, you will feel a heaviness or tightness feeling in your chest. This feeling may also spread to your arms, neck, jaw, back or stomach. The strength of this feeling varies between different people. Some may also experience loss of breath during an attack.
It is very important to understand whether you’re having an angina attack, or if something much more serious is taking place. If you have not been diagnosed with angina and experience chest pain you should call the emergency services immediately. There is always a chance that the pain felt could actually be a heart attack.
If aspirin is easily available and you’re not allergic to it, take one tablet while you are waiting for the ambulance to arrive. If you have an attack and you’ve already been diagnosed you should take your prescribed medicine. A second dose should be taken after five minutes if the first does has no effect.
Angina treatment commonly involves ways of reducing the number of attacks you have, as well as reducing the intensity of the symptoms mentioned above. One of the most common types of medication given to angina patients is glyceryl trinitrate.
These tablets belong to a group of medication known as nitrates. They work by relaxing and widening the blood vessels that increase the heart’s blood supply. One dose of this medication should help to ease the pain during an attack within two to three minutes.
Side effects of this tablet include headaches and dizziness. In order to keep these effects minimal, you should avoid drinking any alcohol whilst taking your tablets. Tablets usually expire after about eight weeks, at which point you will need a new supply. Therefore, you may prefer to use glyceryl trinitrate spray, as it lasts for a longer period of time.
Other medicines are used to help prevent attacks from happening at all. Commonly this will involve you taking at least one form of medication every day for the rest of your life. Your doctor or cardiologist will try one type of medication first to see if this helps before applying a second if this does not work.
Medicines commonly used include:
- Beta-Blockers – These make the heart beat slower with less force. This means that the heart requires less blood and oxygen after exercise. Side effects include tiredness, cold hands and feet, diarrhoea and sickness.
- Calcium Channel Blockers – These relax the muscles which make up the wall of the arteries, increasing blood supply to the heart. Side effects include headaches, dizziness, skin rashes and tiredness, although these should pass after a few days. You should never drink grapefruit juice when prescribed these tablets as this can cause a drop in blood pressure.
- Long-Acting Nitrates – Similar to glyceryl trinitrate, these tablets are designed for the long-term prevention of angina symptoms. Side effects include headaches and a flushed face.
If medication has no effect on your angina symptoms then surgery is often recommended. There are two types of surgery to help treat the condition:
- Coronary Artery Bypass Graft – This includes a section of blood vessel being taken from another part of the body, and being used to re-route the flow of blood past a blocked or narrow section.
- Percutaneous Coronary Intervention – This involves the widening of a narrow artery using a tiny tube known as a stent.
Option one is commonly preferred for those who have diabetes, are over 65 and have blockages in three or more of the blood vessels which supply the heart with blood.
If medication and surgery do not improve your symptoms, the use of psychological or behavioural treatments may be the next option. One example would be cognitive behavioural therapy, which helps to develop your skills to cope with your condition, manage your pain and improve your symptoms.
How to Prevent Angina
In order to reduce the risk of angina you should ensure that you have a healthy lifestyle. It is suggested that you have a diet which is full of fruit and vegetables, which are full of useful vitamins, minerals and fibre. You should also include wholegrain rice, bread and pasta in order to reduce your risk.
You should also avoid eating too much high-fat foods, such as butter, hard cheese, meat pies and sausages. Instead, you should try eating small amounts of unsaturated fats, such as avocados and oily fish, as they increase the level of good cholesterol in your body. Your salt intake should also be less than 6g per day.
Alongside the healthy diet, you should stop smoking. Smoking has a direct link to the narrowing of your arteries, and it also raises your blood pressure. This automatically raises the risk of both heart attacks and strokes.
Drinking too much alcohol has a similar affect on your blood pressure. With this in mind, you need to keep to the guidelines which states that you should not drink more than 14 units a week. Alcohol is also high in calories, so you’ll gain weight if you drink regularly, which can further increase your blood pressure.
With a healthy diet should come an active lifestyle. Taking part in regular exercise helps to keep your heart and blood vessels in a good condition. The healthier you live your life, the better shape your heart will be in.
Living with Angina
Most people with angina are able to live normally and have a good quality of life. Those with the condition should make the lifestyle changes suggested above in order to keep control of their symptoms.
Your doctor will be on hand to advise you on what you should and should not be doing. Knowing your limit is crucial if you have angina, especially if you’re working out. It’s all about balancing the amount of exercise with the severity of your condition. Physical activity may trigger the symptoms of an angina attack. But the more you exercise, the less likely it is you’ll have an attack.
It is advised that those affected avoid high intensity activities such as football and squash. Low-impact activities, such as walking, swimming and cycling, are recommended.
Angina qualifies our customers for VAT Exemption when they order a personal alarm system from Lifeline24. HMRC state that a product which has been “designed or adapted for a disability” qualifies for VAT exemption.
For a person to qualify they must meet certain criteria set by HMRC. These criteria state that the customer must have a long-term illness, a terminal illness or a disability in order to qualify.
Staying safe at home
A personal alarm can help protect people if they suffer from medical conditions. If one of our alarm users feels unwell, or suffers a fall, he or she can press their pendant button and help will be arranged immediately.
For more information on purchasing one of our life-saving personal alarms, please speak to one of our friendly advisors on 0800 999 0400. Alternatively, complete our contact us form and we will get back to you as soon as possible.