Angina

The Dangers of Obesity and Angina

According to the Mayo Clinic, there are a list of factors which directly influence and increase your risk of developing coronary heart disease and the related condition angina. (1) Chewing and smoking tobacco, as well as second-hand smoke damage the interior walls of arteries. This in turn allows cholesterol deposits to build up and can block blood flow and oxygen to the heart. Diabetes is another factor that can have a direct link to angina and heart disease and is also directly related to obesity. High blood pressure, also related to obesity, can also increase your chances of angina and heart disease. High blood cholesterol and a lack of exercise are also both factors that can affect your chances of developing heart disease and angina. In addition to these, there are also factors such as a family history of heart disease, older age and stress that can all influence the risk of developing angina and heart disease.

Causes and explanation

Angina is caused directly by a reduced blood flow to the heart muscle. (2) The blood carries oxygen which feeds the heart. The most common reason why the blood flow to your heart can be reduced is coronary artery disease. Plaque builds up in layers along the arteries leading to your heart, a process known as atherosclerosis. What this process results in is that the blood cannot deliver enough oxygen-rich blood cells to the heart. Most people don’t notice they have any angina symptoms until they start to do some physical exercise - this is because the heart can get by on normal levels of blood-oxygen, but it is only when it requires a higher demand that it can be noticed that there is something wrong.

Symptoms of angina pectoris and coronary heart disease, as well as heart attacks are generally hard to notice and may not reveal themselves for years. However, when a heart attack is imminent, then immediate medical attention should be sought. Symptoms of heart attacks are pressure or pain in the chest that lasts more than a few minutes, pain extending to shoulder, back, arm or even jaw or teeth, pain in the upper abdomen, shortness of breath, sweating, a sense of doom, fainting, nausea and even vomiting. (3)

Obesity and remedies for angina

Because angina pectoris and coronary heart disease is intimately linked to obesity, the best remedy is the preventative one. (4) Reduction of smoking, eating a healthy diet with limited amounts of saturated fat, whole grains and many fruits and vegetables are two of the most common ways to combat early onset of heart disease. A safe exercise plan which includes cardiovascular and workouts is also a good step to take as well as a weight-loss program if you are overweight or obese. Avoiding large meals and taking tests that eliminate factors such as diabetes, high blood pressure and high blood cholesterol are also important steps to consider when trying to combat angina and heart disease related to obesity. Omega-3, l-arginine and l-carnitite are also all supplements that are also found naturally in many foods which can be consumed as part of your regular diet to help keep your arteries clear of plaque and bad cholesterol. (5)

For females in particular, high levels of estrogen may also play a role in the development of angina related to obesity. (6) Other factors that may contribute to the development of angina and heart disease are depression, age, a family history and even economic factors that can result in a poor lifestyle.

Obesity, hypertension, diabetes and cardiovascular disease

Not surprisingly, these four conditions are often very highly interrelated. According to a study conducted in 2002 known as the Framingham experience, a direct correlation can be seen between rising body mass index levels and cardiovascular diseases such as angina pectoris. (7) In particular, new cardiovascular diseases such as angina pectoris, myocardial infarction, coronary heart disease or stroke are all intimately related to being overweight or obese. The conclusion of this study is that being overweight has a direct risk for hypertension and cardiovascular problems. Generally, interventions to reduce adipose tissue (excess body-fat) and excess weight can have significant ameliorations on general cardiovascular health in the body.

Another study conducted on middle aged men determined that increasing weight that led to being overweight or obese in middle aged men had a significant increase in the chances of developing cardiovascular disease as well as diabetes. (8) In this study, men aged 40-59 years were studied over a period of 20 years of which 6,798 were able to provide full information on weight change five years later. A huge amount of data was gathered and in conclusion, it was determined that long term risk of cardiovascular disease as well as diabetes increased very significantly with increasing overweight conditions and obesity in general.

Interesting anomalies

There are also some interesting anomalies in the study of angina pectoris and obesity which illustrate just how little we really know about this phenomena scientifically. In a clinical examination conducted on 104 patients with stable angina. (9) In general, it was observed that the patients had high levels of anxiety, less tolerance to exercise as well as psychosocial maladaptions. The conclusions were that psychological characteristics can be related to angina pectoris and obesity.

Another interesting study conducted in Germany was that obesity is actually involved in improved outcomes of recovery from cardiovascular illness. (10) While this in no way implies that obesity is a good thing, it was ironically observed in this study that men who are obese and recovering from cardiovascular illness ironically have a higher chance of survival than men who are of a regular weight. This has been labeled the ‘obesity paradox.’ A further interesting study that underscores this was also conducted in the European Heart Journal. (11) While they agree with the conclusions of the first study, they add that ‘prevention of an acute coronary event is certainly preferable to a relatively better outcome thereafter.’ In other words: obesity needs to be combatted to prevent heart disease and angina, not to provide a fallback net for better recovery options.

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(1) Angina Risk factors, Mayo Clinic Staff. Retrieved 30th June, 2011, http://www.mayoclinic.com/health/angina/DS00994/DSECTION=risk-factors
(2) Angina Causes, Mayo Clinic Staff. Retrieved 30th June, 2011, http://www.mayoclinic.com/health/angina/DS00994/DSECTION=causes
(3) Angina Complications, Mayo Clinic Staff. Retrieved 30th June, 2011, http://www.mayoclinic.com/health/angina/DS00994/DSECTION=complications
(4) Angina Lifestyle and home remedies, Mayo Clinic Staff. Retrieved 30th June, 2011, http://www.mayoclinic.com/health/angina/DS00994/DSECTION=lifestyle-and-home-remedies
(5) Angina Prevention, Mayo Clinic Staff. Retrieved 30th June, 2011, http://www.mayoclinic.com/health/angina/DS00994/DSECTION=prevention
(6) Angina Basics, lifeheart.com. Retrieved 30th June, 2011, http://www.lifeheart.com/patient/angina/risk_factors.asp
(7) Overweight and obesity as determinants of cardiovascular risk: The Framingham experience, WILSON Peter W. F.; D'AGOSTINO Ralph B.; SULLIVAN Lisa; PARISE Helen; KANNEL William B., Archives of internal medicine, 2002, vol. 162, no 16, pp. 1867-1872 (39.ref). Retrieved 30th June, 2011, http://cat.inist.fr/?aModele=afficheN&cpsidt=13934462
(8) Overweight and obesity and weight change in middle aged men: impact on cardiovascular disease and diabetes, S Goya Wannamethee, A Gerald Shaper, Mary Walker, J Epidemiol Community Health 2005;59:134-139 doi:10.1136/jech.2003.015651. Retrieved 30th June, 2011, http://jech.bmj.com/content/59/2/134.abstract
(9) Clinico-psychological features of patients with angina pectoris and obesity, Gnedov DA, Ter Arkh. 2000;72(1):22-5. Retrieved 30th June, 2011, http://www.ncbi.nlm.nih.gov/pubmed/10687200
(10) Obesity associated with improved outcomes after unstable angina/NSTEMI treated with early revascularization, JUNE 20, 2007 | Michael O'Riordan. Acute Coronary Syndromes. Retrieved 30th June, 2011, http://www.theheart.org/article/797875.do
(11) Effects of obesity on mortality in patients with unstable angina or non-ST-elevation myocardial infarction: reply, Heinz Joachim Buettner, European Heart Journal, Volume28, Issue23, Pp. 2950-2951. Retrieved 30th June, 2011, http://eurheartj.oxfordjournals.org/content/28/23/2950.2.full