The pain is usually described as an ache, pressure, tightness, or burning in the center of the chest or behind the breastbone. It can be brought on by exercise or by exposure to cold, stress, emotional upset, or a heavy meal, and is relieved by rest. Some people also have shortness of breath and palpitations along with chest pain.

Angina Pectoris Treatment. Angina is usually treated with nitroglycerin tablets which dissolve under the tongue. Nitroglycerin relaxes the walls of the blood vessels supplying the heart, allowing more blood and oxygen to reach the heart muscle.

Nitroglycerin may be taken to prevent angina when a situation arises in which an anginal attack usually occurs. It is also taken to treat an attack which is occurring. The most common side effects of nitroglycerin are headache and flushing.

Nitroglycerin tablets gradually lose their potency when exposed to air. Therefore, a container of nitroglycerin tablets which has been opened is good for only about two months. Nitroglycerin is also available as an ointment, or impregnated in a disposable pad.

In this way it is applied directly to the skin, providing continuous pain relief. Other medications used in Angina pectoris treatment are a longacting nitrite similar to nitroglycerin, isosorbide dinitrate (Isordil), and propanolol (Inderal), which reduce the amount of oxygen needed by the heart.

Another way to ward off anginal attacks is to avoid the activity which brings about the angina if possible. A controversial method of treating angina which has not been helped by medical treatment is coronary artery bypass surgery.

In this procedure a vein graft is taken from the leg and is used to bypass the blocked coronary artery, thus providing the heart muscle with an adequate supply of blood and oxygen. At this time, the procedure is thought to be effective only when certain arteries are blocked.

The costs and risks of surgery as well as the pain and disability involved must also be considered. While surgery may help some people with angina, it is not an appropriate angina treatment for everyone.

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It may be caused by high blood pressure, rheumatic heart disease, or atherosclerosis.

Symptoms include shortness of breath; tiredness; swelling of the ankles, legs, and feet (edema); cough; rapid weight gain (from edema); and mental confusion.

Treatment of congestive heart failure depends on both the severity of symptoms and the underlying cause of the illness.

Usual treatment consists of:

- rest

- a low salt/sodium diet

- diuretics (water pills)

- and digitalis, which strengthens the heart muscle.

PREVENTION:

1.    Control high blood pressure, if present, and check yearly for high blood pressure if blood pressure is now within normal range.

2.    Stop smoking.

3.    Exercise regularly. Brisk walking or swimming are good ways to maintain cardiac health.

4.    Maintain ideal weight.

5.    Cut down on animal fats, watch salt intake, eat a variety of foods lean meats, poultry, fish, low fat dairy products, whole grain breads and cereals, fresh fruits and vegetables.

6.    Drink plenty of water.

7.    Get enough rest and relaxation.

8.    Reduce or control emotional stress.

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But you may be able to prevent and reverse some of the disintegrating function of your heart by protecting and strengthening the workings of tiny structures (mitochondria) inside cells that produce and transport the energy that keeps the heart strong and pumping.

It’s a myth that your heart does not weaken as you get older. Several major studies suggest that heart function does not fizzle with age, that an older heart pumps just as well as a younger one. However, that may be true of a heart measured “at rest,” but it’s not true of ordinary aging hearts undergoing the normal stresses of life, according to Jeanne Y. Wei, M.D., director of the division on aging at Harvard Medical School.

Actually, the vital machinery of heart cells becomes increasingly damaged by free radical attacks as you age. Each heart cell, like other cells, has many tiny energy factories, called mitochondria, that are the “respiratory centers,” the life force of cells, that keep them alive and functioning properly.

But with age, large portions of the DNA of these mitochondria are literally chipped away. The weakened mitochondria then have to work harder, they require more oxygen. Consequently, the metabolic functioning of heart mitochondria declines by 40 percent in aged hearts, Dr. Wei says.

In aged animals, the formation of vicious super-oxide radicals in heart mitochondria surges 40 percent; mitochondria membranes become stiffened, stuffed with cholesterol and less efficient at transporting all important ionized calcium that controls heart function.

Microscopic photos of old animals’ heart mitochondria show a scarred and tangled mess compared with those of young animals. This relentless free radical damage to heart mitochondria DNA over the years can lead to enlarged hearts, diastolic dysfunction (when blood flows back into the ventricle), reduction in blood flow, and congestive heart failure, exactly the symptoms that gradually beset aging populations.

Half of all Americans have diastolic dysfunction after age eighty, and congestive heart failure is a growing epidemic, the number one cause of hospitalization for Americans over age sixty five, says Dr. Wei. Rates of congestive heart failure double every decade after age fifty.

“The old heart is simply less able to keep up. When there is something wrong with muscle function, let’s say, or you have hypertension or a touch of arrhythmia, you can’t generate enough energy to pump blood through the heart because you can’t mobilize the machinery inside each of those heart cells to keep the muscles relaxing and contracting appropriately, so the heart will go into failure,” explains Dr. Wei.

Worst of all, this cycle of damage to the heart mitochondria is self-perpetuating and accelerating. The more damaged they become over time, the less able they are to snuff out new damage, and it accumulates, picking up speed, causing more and more severe global heart dysfunction with age.

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As I have mentioned, heart disease is now increasing in developing countries as their populations age and people adopt the unhealthy habits of the affluent West. Look to your children: they may appear healthy enough, but the insidious process of heart disease may already have begun.

Atherosclerosis the narrowing of the coronary arteries due to fatty deposits can start early in life. Its initial stages often occur in children and young people, and it tends to progress silently and without symptoms, until illness strikes.

Yet, while the disease maybe creeping up on people unawares, health experts are now well acquainted with the how and why. Years of research have made it abundantly clear that it is our dangerous lifestyles and unhealthy diets and habits, beginning in early childhood, that lead us slowly and relentlessly to that moment of devastation.

A heart attack is an earth-shattering, sometimes fatal shock to your system the body’s alarm signal, which cannot be ignored. A deadly band of villains conspire to bring about this menace. I think that after reading this book you will recognize them: high blood pressure, cigarette smoking, dietary habits (particularly excessive intake of saturated fat), elevated blood cholesterol and homocysteine levels, lack of physical activity obesity and diabetes.

And lurking in the background are the genetic factors that interact with your environment to bring about added risk. Nevertheless, you can fight back! Even after heart disease strikes, there is plenty of hope through the use of HQ medicine and the HQ approach to restoring wellness.

Of course, I understand that it is hard to think clearly in the midst of the anguish of diagnosis and the realization that you are facing this life threatening disease. It probably doesn’t even register when your physician first tells you what is happening in your body.

There are various stages of the disease, and it is important to find out which one you are in. Medical treatment varies, depending on the severity of the disease, from a simple prescription of aspirin or other “clot buster” drugs to surgery.

Angioplasty, which opens up the blocked artery with a balloon distention, and bypass heart surgery are becoming common procedures. That’s only the beginning. There is a whole distinct dimension of health care for people recovering from heart attacks or heart surgery.

It involves a combination of exercise, health education and counselling, and it can be set up in any community, however small. You don’t have to live in a big city to recover well. The goal is to enable you to return to a useful and personally satisfying role in society.

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1. Coronary Heart Disease And Your Cigarette Smoking Status
2. Risk Factors For Heart Disease
3. Are You At Risk Of Heart Disease If Your Cholesterol Level Is Normal?

When they are clogged with clot or cholesterol, they fail in their function, and damage ensues. A program of lifelong physical exercise is the single most important protection against stopped up pipes and heart trouble.

Exercise confers major advantages on virtually every step in the process that leads to circulatory collapse. Once a heart attack or stroke has occurred, a cure is not only unlikely, but impossible. The doctors struggle to preserve what is left, but when the damage is already don; permanent injury results.

One reason that the recognition of exercise’s preventive force in heart and artery trouble has taken so long to be appreciated is the numbers of reports that indicated the relatively short life expectancy of college athletes.

If exercise were good for you, how come these stars failed to live long lives? The answer now is very simple. Merely because an individual was fit in his or her 20s means little if the level of fitness isn’t sustained into the 60s and beyond.

To provide value, physical exercise must be a lifelong habit. The benefits exercise brings to the fight against heart disease are huge. All of the factors that contribute to heart attacks because of blocked arteries can be addressed by exercise.

Not only does exercise help lower the total blood cholesterol levels, but it alters the types of cholesterol as well. Exercise also helps lower the blood pressure. As you no doubt know, people with higher blood pressure run higher risks of heart disease.

When you exercise, your arteries dilate, and thus the blood has a larger volume within which to be distributed, and in turn blood pressure falls. Want more evidence? Exercise helps smokers quit. Cigarette smoking is a strong predictor of early heart problems.

Almost no one who is physically active smokes. Rather than my trying to convince my heart disease patients to stop smoking, I instead encourage them to start to exercise. It is easier to engage in positive behavior than to stop negative behavior.

More? Exercise cuts down .the clottability of blood, so it is less likely that a block will occur in a crucial artery. There are many medical efforts to thin the blood of people with heart disease. Exercise does it naturally.

Finally, exercise enlarges the arteries. Larger arteries can tolerate more cholesterol sludge passing through. All of these and more provide ample incentive to be fit. Heart surgeons and undertakers probably won’t like it, but as you become better conditioned, your arteries and your heart will thank you for preserving their ability to keep the juices flowing.

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1. Are You At Risk Of Heart Disease If Your Cholesterol Level Is Normal?
2. Heart Disease And Vitamin C
3. Smoking and Heart Diseases

Many studies have shown an association between elevated blood pressure and risk of coronary heart disease and stroke in both women and men.

Studies also have shown that controlling blood pressure through weight reduction and antihypertensive (blood pressure lowering) medication results in a significant reduction in the development of coronary heart disease and stroke.

Regular checkups with your health care provider are important so that elevated blood pressure can be screened, since it generally has no symptoms.

Smoking

Cigarette smoking remains the leading preventable cause of coronary heart disease in women, with more than 50 percent of heart attacks among middle aged women attributable to tobacco. The risk of developing heart disease begins to decline within months of quitting smoking  and reaches the level of those who have never smoked within 3 to 5 years.

While quitting smoking is no easy task, studies have shown that the more times you attempt to quit, the more likely your next try will be successful. Speak to your healthcare provider about setting a date for quitting, obtaining nicotine substitutes, utilizing hypnosis, and joining group therapy. One of these methods might work for you.

Alcohol

Moderate amounts of alcohol (one to two drinks per day) may provide some protection from coronary heart disease. However, higher amounts of alcohol have the opposite effect, causing alcoho related heart disease. In addition, alcohol consumption is linked to several types of cancers, including breast cancer, with intake as little as 2 drinks per day. Thus, you should limit yourself to 1 to 2 drinks per day.

Stress

Mental stress, type A personalities, and job stress all have been linked with the development of coronary heart disease. Recent studies on the effects of relaxation techniques and lifestyle changes that reduce stress show great promise. As a holistic approach to menopausal health, reduce stress by simplifying your life as much as possible and learn relaxation techniques to better handle the stresses that remain.

Preventing Heart Disease

The prevention of heart disease can become a part of every woman’s healthy lifestyle. You should eat a low fat and phytoestrogen rich diet. You should perform cardiovascular exercise at least three times a week. Keep your blood pressure controlled, do not smoke, use alcohol in moderation, and keep stress to a minimum. You will find life enjoyable, your energy high, and personal fulfillment maximized by these important interventions.

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1. Are You At Risk Of Heart Disease If Your Cholesterol Level Is Normal?
2. Managing Coronary Heart Disease
3. Cure Heart Disease With Exercise

At first, all three groups of rodents showed about a 70 percent reduction in the clumping of blood platelets (which helps form blood clots). But when the rats were deprived of alcohol for 18 hours, the
platelet clotting response increased 46 percent in the white wine group and 124 percent in the ethanol group.

But the red wine drinking rats showed a desirable 59 percent drop in clotting response. “The platelets of the rats drinking red wine did not exhibit the rebound effect observed hours after alcohol drinking, eventually associated with sudden death and stroke in humans,” wrote the researchers.

A study by researchers at the Kenneth L. Jordan Heart Foundation and Research Center in Montclair, New Jersey, on the other hand, found that white wine may be more beneficial than red. The researchers had 20 men and women with high cholesterol consume 180 milliliters of either red or white wine every day for a month.

The subjects then switched to the other type of wine for another month. These individuals ate whatever they wanted. While neither group had significant changes in total or “good” HDL cholesterol, the
white wine lowered “bad” LDL cholesterol from 167 to 155 milligrams/deciliter. The researchers also found that both groups’ blood showed a decreased clotting response.

And investigators at the Kaiser Permanente Medical Care Program in Oakland, California, analyzed both red wine drinkers and white wine drinkers and found that both groups have lower risks of coronary heart disease.

The upshot? “Classically, red wine has been thought to be more preventive than white wine, and there’s some persuasive evidence in support of red wine and that it probably has a more complex effect
within the body,” says Dr. Pashkow.

But not every expert agrees that red wine is a better cholesterol buster. “There’s no difference (between red and white wine),” says William P. Castelli, M.D., medical director of the Framingham Cardiovascular Institute, a wellness program at Metro West Medical Center in Framingham, Massachusetts. “All of the scientific evidence points to either one as helping to lower the risk of developing coronary heart disease.”

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Alcohol in modest or great amounts is strongly related to the risk for high blood pressure, and coffee and caffeine lead to mild elevations in some but not all studies. Overweight persons have a higher risk of developing hypertension. Increased demands on the heart and changes in hormone chemistry are thought to explain the risk.

Genetic Hypertension
Familial susceptibility makes offspring significantly more vulnerable to influences of excess sodium and loss of potassium. The genetic factor is relatively small compared to learning experiences and other lifestyle factors.

Diet And Hypertension
Since vegetarians have consistently lower blood pressures than carnivores who also eat meat, the latter practice probably contributes to hypertension. Even utilizing the balance of foods in the government food pyramid nudges people toward a more vegetarian diet.

The better forms of animal protein are deep-sea, cold water fish, consumed at up to three to five meals per week. Sugar. In laboratory rats, groups consuming 10, 15, and 20 percent of total calories as sucrose for 14 weeks had significantly higher systolic blood pressure than rats consuming no sucrose. Sucrose in western diets averages more than 20 percent of calories.

It is also important to avoid high glycemic index foods. Studies in humans also suggest that increased salt retention and elevated blood pressure occur with higher intake of sugars. Nutrient deficiencies. Deficiency in calcium, magnesium, potassium, and zinc from the diet is known to contribute to high blood pressure.

Excess sodium, chiefly from salt, raises blood pressure in the one person out of six who is sodium sensitive. Dehydration, as with coronary artery disease and congestive heart failure, increases risk.
In hypertension there tends to be a deficiency of taurine, a nonessential amino acid obtained in small amounts in food and also synthesized in the body. Food sensitizing agents.

High blood pressure can be a response to food sensitivities. The probability that food sensitivities will play a role is greater in persons with a family history of allergies, those with food cravings or habitual ingestion of great amounts of a few foods, and those whose hypertension seems to come and go.

Careful history taking and food elimination and reexposure trials can identify offending sensitizingfoods. The most common food offenders include chocolate, corn, nuts (especially peanuts), pork, coffee, milk, wheat, rice, beef, shrimp, seafood, chicken, and apples. Caffeine is known to elevate blood pressure and should be avoided by anyone who has even occasional elevated readings.

Environmental Hypertension
Hypertensive patients have higher blood levels of lead (gasoline, paint, drinking water) and three times higher amounts of cadmium (batteries and cigarettes) than nonhypertensive persons. All toxins, including these heavy metals, provoke increased levels of free radicals in the body, and hypertension is on the long list of diseases linked to this problem. Hypertension is more common in persons exposed to inhalant sensitizing agents, including chemical odors (natural gas, gasoline fumes, chlorine), air pollution, auto exhaust,, soft plastic, cleaning chemicals (Lysol, phenol), perfume, polyurethane, tobacco smoke, polyesters, fiberglass, Naugahyde, new carpeting, formaldehyde, pesticides, pest strips, and foam rubber.

The probability that inhalant sensitivities will play a role in hypertension is greater in persons with a personal or family history of allergies and those whose hypertension varies by the season or geographical location. Careful history taking can often identify offending sensitizing agents.

Exercise And Hypertension
If you are sedentary, you increase your risks of hypertension about 50 percent. Since tension accruing from stressful experiences is dissipated during physical exercise, you may simply miss the opportunity to wind yourself down.

The elevated blood pressure that occurs with athletic or vigorous physical exertion is much less damaging because it does not remain sustained after the exertion is terminated. The gradual rise in blood pressures that accompanies aging occurs much less often in people who remain physically fit.

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Initiatives include increasing the intake of whole foods, including vegetables, fruits, whole unrefined grains, legumes, beans, nuts, seeds, fiber, vitamins, minerals, and essential fatty acids.

Only 8 percent of Americans meet the governmental nutritional standard of at least two fruit and three vegetable servings daily.

Increasing fiber to a reasonable level of 15 grams per day requires most Americans to double or triple their intake.

Fiber is found in the same whole foods. While increased fiber intake decreases both bad and good cholesterol, its effect on good cholesterol is much less. Consumption of more fish and fish oils increases omega 3 essential fatty acid intake.

Men eating at least an ounce of fish daily were found to have a 20-year mortality 50 percent lower than that of non fish eaters. If two to three fish servings per week is not feasible, omega 3 oils can be obtained from fish oil capsules in doses of two grams twice a day.

Flaxseed oil, two to three teaspoons daily, supplies large amounts of omega 3 oils as well. Garlic and onions contain active ingredients that tend to lower cholesterol, blood pressure, and risk of certain
cancers.

Alfalfa has been demonstrated in animal studies to regress atherosclerotic plaques and help restore normal structure within arterial walls. If your body stores of the carotenoid lycopene are at highest levels, your risk of heart attack is reduced 50 percent compared to people with low levels.

Food sources are watermelon, guava, pink grapefruit, tomatoes, tomato juice, catsup, and dried apricots. Reduction of saturated and unsaturated hydrogenated fats (meats, whole milk products, margarines), refined (white) flour products, sugar, caffeinated beverages, and alcohol is also high priority.

Oxidized fats those that are becoming rancid and prerancid are to be avoided as much as possible. While many authorities have recommended reduction of high cholesterol foods such as egg yolks, the evidence for any benefit is marginal. Unless your family has a high genetic predisposition, reasonable egg consumption is not an issue.

Sugar is a more important factor than many authorities believe. Substituting sugar for starch in the diet significantly raises triglycerides and reduces good cholesterol; and sugar intake in the United States has been rising steadily for 50 years.

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Please see your own physician before embarking on any treatment program for hypertension.

More advanced cases of high blood pressure may require medication, but I’ve found that changing a person’s diet and lifestyle is often all it takes to bring the pressure back to normal.

Here’s the eight-step program :

1. If the blood pressure is dangerously elevated, get it down as quickly and safely as possible, using medications when necessary. Some medicines work well with relatively mild side effects. I tell my patients that we must quickly lower the blood pressure to prevent a “brain attack” (stroke). As soon as the lifestyle and other changes begin taking effect, however, we can often reduce and eventually eliminate the medications altogether.
2. Change your lifestyle and eliminate as much stress as possible. In the case of emotional stress, the problem is not what happens to us, but, rather, how we respond to it. “Thought disease” can cause hypertension, but we can help to protect ourselves by learning to look upon challenges as NICE (new, interesting, challenging experiences), rather than to view them with FUD (fear, uncertainty and doubt).  “Thought disease,” the major scourge of our time, is caused by germs of the mind such as anger, fear, frustration, loneliness, alienation, unforgiveness and others. But we unknowingly bring “Thought disease” on ourselves. Other people do not make us think harmful, negative thoughts. We, and only we, decide what we will think.
3. Learn meditation and relaxation techniques to help keep stress at bay.
4. Maintain normal body weight. Shedding excess fat is very important and can help bring high blood pressure back down to normal.
5. Adopt a high complex-carbohycfrate diet based on fresh vegetables, whole grains and fruit, with smaller amounts of low fat protein and dairy products. Avoid the dangerous “CATS from San Francisco” (caffeine, alcohol, tobacco, sugar, salt and fat).
6. Take carefully calculated doses of magnesium, calcium, potassium and other supplements.
7. For unremitting anxiety, I recommend a homeopathic remedy put out by Enzymatic Therapies called L.72 Anti-Anxiety. It is a complex mixture of many remedies, including Cicuta virosa 4x, Ignatia 4; Staphsagria 4x and Asfoetida 3x. I havefound this to be an effective anxiolytic that I’ve used to help people whose elevated blood pressure was due to nervousness or anxiety. I also use an herb called Kava kava (piper methysticum) to relieve anxiety.
8. In many cases, it may be helpful to undergo a 24-hour Ambulatory Blood Pressure Monitoring (ABPM) to detect “hidden” hypertension. ABPM can also show what drives your pressure up work, traffic, tense family situations, etc. Later, ABPM is a valuable tool for following the course of improvement during hypertension treatment.  Blood pressure goes up and down during the day, as we commute, work, eat lunch, meet with friends, relax, play softball, go shopping, laugh, converse and get angry. If your blood pressure is checked only once during a medical visit, it won’t reveal the entire picture. It’s a good idea to have your blood pressure checked by a doctor. You should also check it regularly at home, as well. One reading, especially in a doctors office where the patient may be nervous, is not enough to establish a diagnosis of high blood pressure. However, the blood pressure reading must be taken correctly if it is to be of any value. (A surprising number of health care professionals do not measure patients’ blood pressures properly.) The ABPM blood pressure monitor consists of a blood pressure cuff worn around the upper arm and a small box-like device that can be worn like a purse or attached to the belt. The patient wears the device for 24 hours. The patient also keeps a diary of everything done during the day. The readings are computer-analyzed and compared to the diary to find out exactly how the patients’ blood pressure responds to everyday events and stresses. Using the ABPM, I’ve found many “hidden” hypertensives, as well as situations where blood pressure is usually normal, but rises dangerously when the patient is in stressful situations (such as arguing with a spouse or being harassed at work).

How should blood pressure be taken?

Simply talking about certain subjects can raise the blood pressure, so you should be silent, seated, relaxed and calm. Eating may falsely elevate the reading, so some time should have passed since your last meal.

• Your arm should be relaxed and at the level of the heart not higher up or hanging down
• Your fist should be relaxed. (Clenching your fist can raise your pressure.)
• You should not be pushing against anything with either arm.
• You shouldn’t be chewing gum, and shouldn’t have recently had coffee, smoked a cigarette or taken over the counter drugs containing caffeine or phenylpropanolamine (a medicine used to suppress appetite).
• And you should be silent.
• The blood pressure cuff should fit snugly around the upper arm, just above the elbow.
• It should be at the level of your heart, and not hanging down low.
• The first time, the doctor should take your pulse at the wrist.
• With one hand on your pulse, the other pumping up the blood pressure cuff, he or she should keep pumping until the pressure has obliterated the pulse.
• Now above the systolic pressure, he or she an let pressure out of the cuff, listening for the first sound with the stethoscope

When I find elevated blood pressure, I usually ask the patient to lie down and relax. Then I repeat the reading after he or she has rested for 20 minutes, often finding that the pressure has fallen to acceptable levels. Your blood pressure should always be measured in both arms. With certain diseases, the pressure will be different, and finding significantly different pressure from right arm to left can be an important diagnostic clue.

Getting the right blood pressure reading is an important first step in combating hypertension. Although hypertension is a potentially serious problem, it can often be controlled.

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