Learn what a typical Angina, stable prognosis is at Consumer Reports Health.

Angina, stable

What will happen to me?

If you've been told you have angina, you might feel anxious about your future and worry that you could have a heart attack.

The good news is that, with treatment, many people with angina can live for a long time.

Source:
Julian DG, Bertrand ME, Hjalmarsson A, et al.
Management of stable angina pectoris.
European Heart Journal. 1997; 18: 394-413.

¹ And making some changes in the way you live, such as stopping smoking and eating sensibly, can also help you live longer and in good health. For more, see What you can do to help yourself.

The bad news is that having angina probably means that you have coronary artery disease. With this disease, the arteries that carry blood to your heart are narrowed, so less blood can get through. If an artery gets badly blocked, you can have a heart attack. Having angina means you are more likely to die early from a heart attack.

Source:
Rosengren A, Wilhelmsen L, Hagman M, et al.
Natural history of myocardial infarction and angina pectoris in a general population sample of middle-aged men: a 16-year follow-up of the Primary Prevention Study, Goteborg, Sweden.
Journal of Internal Medicine. 1998; 244: 495-505.

One study looked at men ages 42 to 65 who had recently been diagnosed with angina but who had not had a heart attack.

Source:
Lampe FC, Whincup PH, Wannamethee SG, et al.
The natural history of prevalent ischemic heart disease ion middle aged men.
European Heart Journal. 2000; 21: 1052-1062.

³ Here's what it showed.

Five years later, nearly 90 percent of the men with angina were alive. This compared with 96 percent of men who didn't have signs of coronary artery disease.
Ten years later, slightly more than 70 percent of the men with angina were alive. This compared with slightly more than 90 percent of the men who didn't have signs of coronary artery disease.

Getting a diagnosis of angina at least gives you some warning that you have coronary artery disease, so you and your doctor can do something about it. Only a third of people with the disease get this warning.

Source:
Gandhi MM, Lampe FC, Wood DA.
Incidence, clinical characteristics and short term prognosis of angina pectoris.
British Heart Journal. 1995; 73: 193-198.

⁴ A third die suddenly (from a condition called sudden cardiac death). And a third get a heart attack without any warning.

The outlook for you depends on many things, including how badly your arteries are narrowed. For example, the outlook is good if you don't need surgery. On average, each year only 1 percent to 2 percent of people with heart problems, such as angina, who don't need surgery die from a heart attack, and a further 2 percent to 3 percent have a heart attack but get better.

Source:
CASS Principle Investigators and their Associates.
Coronary Artery Surgery Study (CASS): a randomised trial of coronary artery bypass surgery survival data.
Circulation. 1983; 68: 939-950.

⁵

Source:
Brunelli C, Cristofani R, L'Abbate A.
Long-term survival in medically treated patients with ischaemic heart disease and prognostic importance of clinical and electrocardiographic data: the Italian CNR multicentre prospective study OD1.
European Heart Journal. 1989; 10: 292-303.

⁶

Source:
Dargie HJ, Ford I, Fox KM, et al.
Total Ischaemic Burden European Trial (TIBET): effects of ischaemia and treatment with atenolol, nifedipine SR and their combination on outcome in patients with chronic stable angina.
European Heart Journal. 1996; 17: 104-112.

⁷

Source:
IONA study group.
Effect of nicorandil on coronary events in patients with stable angina.
Lancet. 2002; 359: 1269-1275.

⁸

But some people with angina are more likely to have a heart attack. Here are some things that can increase your risk of having one.

You are a man.

Source:
Murabito JM, Evans JC, Larson MG, et al.
Prognosis after the onset of coronary heart disease: an investigation of differences in outcome between sexes according to initial coronary disease presentation.
Circulation. 1993; 88: 2548-2555.

⁹
You get angina without much exercise. A stress test may show this. About one-third of people with stable angina who are sent to the hospital get angina without much physical activity.

Source:
Mock MB, Ringqvist I, Fisher LD, et al.
Survival of medically treated patients in the coronary artery surgery study (CASS) registry.
Circulation. 1982; 66: 562-568.

¹⁰ For more on stress tests, see Tests for angina.
You have an abnormal electrocardiogram (ECG for short) while you are resting.

Source:
Hammermeister KE, De Rouen TA Dodge HT.
Variable predictors of survival in patients with coronary heart disease.
Circulation. 1979; 59: 421-430.

¹¹ About half of people with stable angina have this.

Source:
Connolly DC, Elveback LR, Oxman HA.
Coronary heart disease in residents of Rochester Minnesota IV.
Mayo Clinic Proceedings.1984; 59: 247-250.

¹² For more on ECGs, see Tests for angina.
You have had a heart attack in the past.

Source:
Rosengren A, Wilhelmsen L, Hagman M, et al.
Natural history of myocardial infarction and angina pectoris in a general population sample of middle-aged men: a 16-year follow-up of the Primary Prevention Study, Goteborg, Sweden.
Journal of Internal Medicine. 1998; 244: 495-505.

²
Your heart isn't pumping well, especially on the left side. In this case, you might also get breathless very easily and have

heart failure
When the heart loses its ability to push enough blood through the circulation, it is called heart failure.

heart failure.

Source:
Mock MB, Ringqvist I, Fisher LD, et al.
Survival of medically treated patients in the coronary artery surgery study (CASS) registry.
Circulation. 1982; 66: 562-568.

¹⁰
You have narrowing of the main

coronary arteries
Coronary arteries are the vessels that supply blood to the heart muscle. If yours are blocked, you may have a pain in your chest (known as angina) or a heart attack because parts of the heart are not getting enough blood and oxygen.

coronary artery going to the left side of your heart. Or you have narrowing of all of your coronary arteries.

Source:
Gandhi MM, Lampe FC, Wood DA.
Incidence, clinical characteristics and short term prognosis of angina pectoris.
British Heart Journal. 1995; 73: 193-198.

⁴

Source:
Mock MB, Ringqvist I, Fisher LD, et al.
Survival of medically treated patients in the coronary artery surgery study (CASS) registry.
Circulation. 1982; 66: 562-568.

¹⁰
You have other factors that make your risk higher, such as smoking,

high blood pressure
Your blood pressure is considered to be high when it is above the accepted normal range. The usual limit for normal blood pressure is 140/90. If either the first (systolic) number is above 140 or the lower (diastolic) number is above 90, a person is considered to have high blood pressure. Doctors sometimes call high blood pressure "hypertension."

high blood pressure,

diabetes
Diabetes is a condition that causes too much sugar to circulate in your blood. It happens when your body stops making a hormone called insulin (type 1 diabetes) or when insulin stops working (type 2 diabetes).

diabetes or

high cholesterol
If you've been told that you have high cholesterol it usually means that your total cholesterol level is 240mg/dL or higher. But doctors also look at the amount of good (HDL) and bad (LDL) cholesterol you have in your blood. Having high levels of bad cholesterol can make it more likely that you'll get certain diseases in your heart and arteries.

high cholesterol.

Source:
Sigurdsson E, Sigfusson N, Agnarsson U, et al.
Long-term prognosis of different forms of coronary heart disease: the Reykjavik Study.
International Journal of Epidemiology. 1995; 24: 58-68.

¹³

Source:
Hagman M, Wilhelmsen L, Pennert K, et al.
Factors of importance for prognosis in men with angina pectoris derived from a random population sample.
American Journal of Cardiology. 1988; 61: 530-535.

¹⁴

Source:
Rosengren A, Hagman M, Wedel H, et al.
Serum cholesterol and long-term prognosis in middle-aged men with myocardial infarction and angina pectoris: a 16-year follow-up of the Primary Prevention Study in Goteborg, Sweden.
European Heart Journal. 1997; 18: 754-761.

¹⁵
Your angina is getting worse or the pattern is changing.

Source:
Gibbons RJ, Abrams J, Chatterjee K, et al.
ACC/AHA 2002 guideline update for the management of patients with chronic stable angina.
November 2002. Available at http://circ.ahajournals.org/cgi/reprint/107/1/149 (accessed on 16 February 2009).

¹⁶

If you're at higher risk for a heart attack, you need to find out early so that you can get the best treatment right away.

Taking medications and making healthy changes to your life will help you avoid having a heart attack. Your doctor may also suggest you consider one of two operations. These are coronary angioplasty and coronary artery bypass graft. Both operations help improve the flow of blood to your heart.

How will angina affect my life?

You might worry about doing your usual activities or enjoying life as normal. The good news is that with the right treatment, many people with angina can keep doing the things they enjoy.

Work

Having angina can affect certain kinds of work. For example, you might no longer be able to do a job that involves running heavy machinery or driving certain kinds of vehicles. Ask your doctor about this.

Driving

You should still be able to drive, as long as your angina is under control. Ask your doctor if you have to tell your state's department of motor vehicles (DMV) and your car insurance company.

Sex

You might worry that having sex will bring on your angina. But most people can still enjoy sex.

If you're taking medications called nitrates, you shouldn't take certain drugs for erection problems. Some of these drugs (with brand names) are listed below.

sildenafil (Viagra)
tadalafil (Cialis)
vardenafil (Levitra)

Nitrates can lower your blood pressure, and these other drugs can lower it even more. That can be dangerous.

If you worry about having sex, talk to your doctor. You might feel embarrassed about bringing this up. But sex is a normal part of life. Your doctor is used to dealing with sexual problems. He or she may be able to help you and your partner.

If your doctor has any doubts, he or she might suggest a stress test to see how much exercise is safe for you. For more, see Tests for angina.

Flying

You might wonder if it's safe for you to travel by airplane. Generally, if you can climb 12 stairs and walk about 55 yards on flat ground without getting very breathless and without getting angina, you can fly as a passenger.

Source:
Jackson G.
Sexual intercourse and stable angina pectoris.
American Journal of Cardiology. 2000; 86 (supplement 1): 35-37.

¹⁷

Depression

Having angina can affect how much you get out of life. You might worry so much about your condition that you feel you have to take it easy and can't live life normally.

Source:
Lewin RJP.
Improving quality of life in patients with angina.
Heart. 1999; 82: 654-655.

¹⁸

You might think of an angina attack as a sort of mini heart attack (it isn't). This might make you feel as though you have to stop doing things you enjoy.

Source:
Lewin B.
The psychological and behavioral management of angina.
Journal of Psychosomatic Research. 1997; 43: 453-462.

¹⁹ And this can give you more anxiety and even depression.

If you're worried or feeling down, talk to your doctor about a self-help angina plan. This plan is based on a workbook and a relaxation tape. If you have newly diagnosed angina, the plan can help you feel better and have less anxiety and depression. You work with a nurse who helps you change the way you live and advises you about medication.

Source:
Lewin RJP, Furze G, Robinson J, et al.
A randomised controlled trial of a self-management plan for patients with newly diagnosed angina.
British Journal of General Practice. 2002; 52: 194-201.

²⁰

Sources for the information on this page:

Julian DG, Bertrand ME, Hjalmarsson A, et al.Management of stable angina pectoris.European Heart Journal. 1997; 18: 394-413.

Rosengren A, Wilhelmsen L, Hagman M, et al.Natural history of myocardial infarction and angina pectoris in a general population sample of middle-aged men: a 16-year follow-up of the Primary Prevention Study, Goteborg, Sweden.Journal of Internal Medicine. 1998; 244: 495-505.

Lampe FC, Whincup PH, Wannamethee SG, et al.The natural history of prevalent ischemic heart disease ion middle aged men.European Heart Journal. 2000; 21: 1052-1062.

Gandhi MM, Lampe FC, Wood DA.Incidence, clinical characteristics and short term prognosis of angina pectoris.British Heart Journal. 1995; 73: 193-198.

CASS Principle Investigators and their Associates.Coronary Artery Surgery Study (CASS): a randomised trial of coronary artery bypass surgery survival data.Circulation. 1983; 68: 939-950.

Brunelli C, Cristofani R, L'Abbate A.Long-term survival in medically treated patients with ischaemic heart disease and prognostic importance of clinical and electrocardiographic data: the Italian CNR multicentre prospective study OD1.European Heart Journal. 1989; 10: 292-303.

Dargie HJ, Ford I, Fox KM, et al.Total Ischaemic Burden European Trial (TIBET): effects of ischaemia and treatment with atenolol, nifedipine SR and their combination on outcome in patients with chronic stable angina.European Heart Journal. 1996; 17: 104-112.

IONA study group.Effect of nicorandil on coronary events in patients with stable angina.Lancet. 2002; 359: 1269-1275.

Murabito JM, Evans JC, Larson MG, et al.Prognosis after the onset of coronary heart disease: an investigation of differences in outcome between sexes according to initial coronary disease presentation.Circulation. 1993; 88: 2548-2555.

Mock MB, Ringqvist I, Fisher LD, et al.Survival of medically treated patients in the coronary artery surgery study (CASS) registry.Circulation. 1982; 66: 562-568.

Hammermeister KE, De Rouen TA Dodge HT.Variable predictors of survival in patients with coronary heart disease.Circulation. 1979; 59: 421-430.

Connolly DC, Elveback LR, Oxman HA.Coronary heart disease in residents of Rochester Minnesota IV.Mayo Clinic Proceedings.1984; 59: 247-250.

Sigurdsson E, Sigfusson N, Agnarsson U, et al.Long-term prognosis of different forms of coronary heart disease: the Reykjavik Study.International Journal of Epidemiology. 1995; 24: 58-68.

Hagman M, Wilhelmsen L, Pennert K, et al.Factors of importance for prognosis in men with angina pectoris derived from a random population sample.American Journal of Cardiology. 1988; 61: 530-535.

Rosengren A, Hagman M, Wedel H, et al.Serum cholesterol and long-term prognosis in middle-aged men with myocardial infarction and angina pectoris: a 16-year follow-up of the Primary Prevention Study in Goteborg, Sweden.European Heart Journal. 1997; 18: 754-761.

Gibbons RJ, Abrams J, Chatterjee K, et al.ACC/AHA 2002 guideline update for the management of patients with chronic stable angina.November 2002. Available at http://circ.ahajournals.org/cgi/reprint/107/1/149 (accessed on 16 February 2009).

Jackson G.Sexual intercourse and stable angina pectoris.American Journal of Cardiology. 2000; 86 (supplement 1): 35-37.

Lewin RJP.Improving quality of life in patients with angina.Heart. 1999; 82: 654-655.

Lewin B.The psychological and behavioral management of angina.Journal of Psychosomatic Research. 1997; 43: 453-462.

Lewin RJP, Furze G, Robinson J, et al.A randomised controlled trial of a self-management plan for patients with newly diagnosed angina.British Journal of General Practice. 2002; 52: 194-201.

This information was last updated on Apr 14, 2009

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