Nutrients to Address Angina

Angina pectoris, a feeling of tightness or pressure in the chest, results from a blockage in one of the coronary arteries; integrative therapy and nutrition can help in prevention and treatment.

 One of the hardest working muscles in the body is the heart, which is constantly supplied with necessary oxygen and nutrients via the coronary arteries. When one of the three major coronary arteries becomes narrowed or blocked, blood flow to the heart is reduced, resulting in angina pectoris—a feeling of tightness or pressure in the chest often associated with shortness of breath. At first, angina may only be obvious during periods of exercise or emotional stress, and may go away when the activity ceases. Later, it may occur even while resting. If the blood flow to an area of the heart completely stops, heart muscle cells die, causing a heart attack (myocardial infarction). While healing, the infarcted or damaged area forms a scar, but is no longer a functioning part of heart muscle.

Conventional medical treatments for angina include blood vessel dilators, such as nitroglycerine, and other nitrites and calcium channel blockers. If arteriograms show clogged coronary arteries, bypass surgery is usually recommended. An integrative approach, including a diet low in saturated fat and certain nutritional supplements, may also be considered to help prevent or even treat angina.

One of the important areas for nutritional intervention is antioxidants to help prevent oxidative damage. Free radicals seem to be involved in almost every cardiovascular condition, and angina is no exception.(1,2) Studies have shown adults with lower blood levels of vitamin C have a higher risk for angina.(3,4,5,6) Furthermore, research has also shown vitamin C supplementation, with or without other antioxidants, has been able to reduce the incidence of angina.(7,8,9)

Often, vitamin C is seen in combination with vitamin E, which is considered by many to be the granddaddy of all antioxidant and cardiovascular support vitamins. Research shows blood levels of vitamin E are significantly lower in patients with angina and that these lower levels render them more susceptible to further cardiovascular damage.(10,11,12) Incidentally, various studies show vitamin E supplementation, with or without other antioxidants, is able to successfully decrease the incidence of angina in affected patients.(13,14,15) One study in more than 2,300 men found vitamin E supplementation had a strong association with a reduced risk of ischemic heart disease, including angina.(16) Finally, vitamin E supplementation, together with conventional anti-anginal drug therapy, has been found to bring a higher response and exercise improvement, as well as other positive changes, than drug therapy alone.(17)

Another important antioxidant in the cardiovascular realm is coenzyme Q10 (CoQ10), a vitamin-like substance involved in cellular energy metabolism. A recent research review noted CoQ10 could be used in oral form to treat various cardiovascular disorders, including angina.(18) Positive results were also found in a study of patients with acute myocardial infarction who experienced a significant reduction in angina, arrhythmias (abnormal heartbeat) and poor heart function, when supplemented with 120 mg/d of CoQ10.(19)