ANGINA TREATMENT

Anyone consulting a doctor with angina symptoms is likely to be given a prescription. for nitroglycerine (also known as glyceryl trinitrate). But rather than causing an explosion, nitroglycerine tablets can help patients to deal with the onset of attacks, easing the chest pain and tightness by increasing the supply of blood and oxygen to the heart. As the slogan for travellers' cheques goes — don't leave home without them. But in addition to medication, there are plenty of ways to cope with angina attacks, reduce their frequency or even prevent them from happening at all.

Immediate measures

• If you're standing, walking around or exercising when an attack occurs, sit down and rest for a few minutes.

• If you're lying down or resting when the telltale pressure presents itself, change your body position by sitting or standing up. That takes pressure off the nerve in your heart that is signalling pain. Angina that occurs when you are resting is a sign that you may be at much higher risk of a heart attack, so contact your doctor as soon as possible.

•  If the attack comes on when you're emotionally excited or anxious, try to calm yourself. Like physical stress, mental stress can increase your heart's demand for oxygen. Do your heart a favour by learning yoga, tai chi, meditation or some other stress-relieving technique that you can practice regularly. 

Help your heart with foods and supplements

• Several studies have shown that a clove of garlic a day can lower high cholesterol and there is evidence that garlic also reduces the tendency of blood to clot — another heart benefit. Eat it raw for maximum effect. If you can't stand the smell, take garlic capsules instead. Choose capsules that supply 4000mcg of allicin and take 400mg to 600MG a day.

•  Folic acid and vitamin B12 are vitamins that lower raised levels of homocysteine, a substance in the blood that can increase your risk of heart disease. The best source of these vitamins may be dietary — some studies have questioned the benefits of supplements. Eat plenty of meat, fish or eggs for B12 and leafy vegetables and citrus fruits for folic acid. Other research suggests that you can cut your risk of heart disease by raking 400mcg of folic acid and 0.5mg of vitamin B12 a day. (Alert If you have coronary heart disease, check with your doctor before taking folic acid and Vitamin B12 supplements.).

• Omega-3 fatty acids protect the heart and blood vessels and may help protect against angina. They are found in fish oil capsules, though if you eat oily fish — such as mackerel or sardines — twice a week, you need not take capsules. Check with your doctor before taking the supplements to be sure they won't interact with medications you are taking. Look for a supplement that provides 1000mg combined EPA/DHA (eicosapentaenoic and docosahexanoic acids) a day. This may mean taking a capsule labelled as 3000mg fish oil or more. 

The power of prevention

• Work out an exercise programme, with your doctor's guidance; regular exercise can help to ward off angina pain. • If you smoke, quit. The nicotine in cigarettes constricts the arteries, triggering angina or making it worse. And stay away from smoky environments, too.

• Give up coffee. Coffee has been linked to raised homocysteine levels, which increase the risk of angina attacks.

• After eating a large meal, rest or engage in a quiet activity. When you consume a heavy meal, the body diverts extra bloodflow to the digestive tract to aid digestion; so the heart receives less oxygen and is more vulnerable to an attack.

• Don't stay outdoors in cold weather. Cold air stimulates muscular reflexes that can cause angina.

• Avoid sudden physical exertion, such as running to catch a bus or lifting a heavy object.

• Try to maintain a healthy body weight. Eat five portions of fruit and vegetables a day and plenty of wholegrain cereals and starchy foods such as potatoes, pasta and rice. Cut down on fatty foods, particularly fried foods, biscuits and chocolate; and choose skimmed or semi-skimmed milk. Eat lean meat in preference to fatty cuts and fish at least twice a week. Keep spreads and oils to a minimum and vary them — olive oil for salad dressings and a polyunsaturated fat spread, for example. A moderate intake of red wine may also be helpful.