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Medical Author:

John P. Cunha, DO, FACOEP

John P. Cunha, DO, FACOEP

John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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Medical Editor:

Daniel Lee Kulick, MD, FACC, FSCAI

Daniel Lee Kulick, MD, FACC, FSCAI

Dr. Kulick received his undergraduate and medical degrees from the University of Southern California, School of Medicine. He performed his residency in internal medicine at the Harbor-University of California Los Angeles Medical Center and a fellowship in the section of cardiology at the Los Angeles County-University of Southern California Medical Center. He is board certified in Internal Medicine and Cardiology.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Prevention

The best action is to reduce risk factors early in life. The goal is to not have angina, a heart attack, or sudden death in the first place. Although no one can escape aging, inherited risk, or gender, certain risk factors are in your control.

• Stop smoking and using nicotine in any form.
  
  
• Control high blood pressure.
  
  
• Lower blood fats (through diet, exercise, and medications).
  
  
• Maintain a healthy weight.
  
  
• Control diabetes and blood sugar
  
  
• Do not use stimulants such as cocaine or amphetamines.

If a person already has atherosclerosis and angina, they can learn to take precautions to avoid having symptoms. Avoiding the "triggers" will help keep the person comfortable and free of symptoms.

• Quit smoking
  
  
• Do not use caffeine, cocaine, amphetamines, or other stimulants
  
  
• Drink alcohol moderately (no more than 1-2 drinks daily)
  
  
• Avoid large and heavy meals that leave you feeling "stuffed"
  
  
• Decrease stress
  
  
• Establish a regular exercise routine (discuss the plan with your healthcare provider)

The question of exercise for a person with angina is important. Exercise is recommended.

• If the patient has been exercising strenuously, they may need to cut back to avoid symptoms.
  
  
• If the patient has not been exercising, or has been exercising moderately, talk to a healthcare provider first about physical activity that will be safe and comfortable. Sometimes a structured cardiac rehabilitation program is a beneficial way to begin an exercise program.

The healthcare provider may recommend taking an aspirin daily.

• Aspirin has been shown to reduce the risk of a second heart attack in people who have already had one, and may reduce the risk of a first heart attack.
  
  
• Taking aspirin is not without risks, especially in elderly people, people with digestive diseases or blood clotting disorders, and people who take certain types of medications.
  
  
• Allergy to aspirin is not uncommon. Tell your healthcare provider if you are allergic to aspirin or have a reaction to aspirin.