Causes

Angina is a problem of supply and demand. Your coronary arteries supply the heart with oxygen and nutrients, and the demand is the amount of work your heart has to do, which is determined by how hard it is to pump your blood around the body. When blockages have built up in your coronary arteries, the blocked artery can’t increase blood supply to meet the demand, and this causes angina.

Coronary artery disease (CAD) and atherosclerosis

CAD is caused by atherosclerosis—a buildup of fatty deposits (plaque) on the inside of the vessels that leads to the restriction or obstruction of blood flow through affected arteries—which is the process behind the supply and demand problem that causes angina. There’s no cure for CAD and atherosclerosis, but it’s possible to slow the process with lifestyle changes, medications, and interventional or surgical procedures.

Risk factors

Because CAD most often causes angina, most of the risk factors for angina and CAD are the same, which include the following:

High cholesterol
High blood pressure
Smoking
Diabetes
Obesity
Lack of physical activity
Age (greater for men* over 45 years and women* over 55 years)
Family history of heart disease
Stress and anxiety
Sleep deprivation
For women, a history of preeclampsia and pregnancy-related diabetes

It’s also helpful to know what triggers your angina symptoms. Track your angina to record what you were doing each time before you had angina symptoms.

Here are some common triggers to monitor and avoid, if possible:

Very hot or very cold temperatures
Big meals
Physical activity
Emotional stress
Drinking (alcohol)
Smoking

Of course, it’s impossible to avoid every single trigger, and it’s also not good for you to give up all physical activity. In fact, regular exercise is one of the best things you can do for your heart. Talk to your doctor about your options for staying active while treating your angina.

*The term “men” in the context of “cardiovascular health” applies to individuals assigned male at birth (AMAB) who have a male biological reproductive system, which includes a penis, scrotum, testes, epididymis, vas deferens, prostate, and seminal vesicles.

*The term “women” in the context of “women’s cardiovascular health” applies to individuals assigned female at birth (AFAB) who have a female biological reproductive system, which includes a vagina, uterus, ovaries, Fallopian tubes, accessory glands, and external genital organs.