Angina and Blood Pressure: Everything You Need to Know

Angina is the name given to a collection of symptoms, including pain or discomfort in the chest and other areas of the body caused by reduced blood flow to the heart. Since this is often a result of coronary heart disease, angina is often seen as a warning that you’re at risk of more serious problems, like heart attacks and strokes.

In this guide, we talk through angina symptoms, causes and treatment and explore its links to high blood pressure (hypertension) and low blood pressure (hypotension).

Angina symptoms

Angina is the pain or uncomfortable feeling you experience when blood flow to your heart is reduced. It usually feels like pressure or tightness in your chest, which may be painful or feel more like a dull ache. Some people also feel pain in their shoulders, arms, neck, jaw, back or stomach.

Other symptoms of angina can include:

Fatigue
Dizziness
Sweating
Feeling sick
Shortness of breath

It can be difficult to tell the difference between angina and a heart attack as the symptoms can be so similar. If it’s angina, symptoms usually ease or go away after a few minutes of rest, or after taking prescribed medication. With a heart attack, your symptoms are less likely to ease or go away after resting or taking medicines.

If you have sudden chest pain that lasts more than 15 minutes, you could be having a heart attack. Call 999 immediately.

What causes angina?

The most common cause of angina is coronary heart disease. This is when a fatty substance, known as plaque, builds up around the walls of the arteries that supply your heart muscle with blood and oxygen in a process known as atherosclerosis. The arteries become narrow, meaning less blood flows to your heart. At times when your heart needs more blood and oxygen than usual, for instance when you’re physically active, you may experience angina symptoms.

A heart attack happens when a coronary artery becomes blocked by a blood clot. This usually happens when the fatty material breaks off inside the artery and blood forms a clot around it.

Common triggers for angina pain include physical activity, stress, cold weather and eating a big meal. This last one is important as sometimes people confuse angina with indigestion. If mealtimes are making your angina worse, try eating smaller portions, more often.

Several factors that can increase your risk of coronary heart disease and angina, including:

Having an unhealthy diet or being overweight
Not getting enough physical activity
Smoking
Having diabetes
Getting older
Having a family history of heart problems
Having high blood pressure
Having low blood pressure

Angina and high blood pressure

If you’ve been diagnosed with angina and hypertension, you may be wondering how the two conditions are interlinked. As we mentioned above, having high blood pressure can make you more susceptible to atherosclerosis and angina. This is because, over time, high blood pressure can damage the lining of your arteries, making it easier for fatty plaque deposits to build up there.

If you already have angina, high blood pressure could make your symptoms worse and increase your risk of having a heart attack. If you have high blood pressure, it’s essential that you try to reduce it.

Angina and low blood pressure

A reading under 90/60mmHg is considered low blood pressure, or hypotension. The symptoms – which can include dizziness and fainting – are usually more unpleasant and disruptive than dangerous.

In some cases, however, it can be more serious. If blood pressure is too low, not enough blood reaches all parts of the body, meaning organs don’t get the nutrients and oxygen they need to function properly. And if the heart muscle doesn’t receive an adequate blood supply, that’s when angina symptoms could make an appearance.

How is angina treated?

The treatment you’re offered will depend on how severe your angina is. While there’s no cure for coronary heart disease, medication will improve symptoms and help your heart to function better. At the same time lifestyle changes, such as an improved diet or stopping smoking, can prevent your condition and symptoms from getting worse.

You may be given medicine to:

Treat attacks when they happen
Prevent further attacks
Reduce the risk of heart attacks and strokes

If medicines aren’t suitable or don’t help, you may be offered coronary angioplasty or coronary artery bypass surgery to improve the blood supply to your heart muscle.

If your symptoms are well controlled and you’re able to make a few lifestyle changes, you can usually have a normal life with angina. Your doctor or nurse may recommend that you:

Stop smoking
Smoking is a major cause of coronary heart disease. According to the British Heart Foundation, stopping smoking is the single most important thing you can do to live longer.
Control high blood pressure
High blood pressure can damage the lining of your arteries. If you have angina, high blood pressure can make symptoms worse and increase the risk of having a heart attack.
Eat healthily
A healthy diet that includes plenty of fruit and vegetables, healthier fats and high-fibre foods help to reduce your risk of coronary heart disease.
Exercise regularly
Physical activity helps keep your heart healthy, control high blood pressure, improve cholesterol levels and boost mental health.
Reduce stress
Relaxation is important if you have angina, so try to find an activity or hobby that helps you to switch off.

Final thoughts

Angina is often referred to as a warning sign or wake-up call for those who need to start taking better care of their health. Whether you’ve been diagnosed with angina, high blood pressure, or both, it’s never too late to start listening to your body and making healthier choices.