Angina - Who Is at Risk for Angina? - Risk Factors

Genetic or lifestyle factors can cause plaque to build up in your arteries as you age. This means that your risk for ischemic heart disease and angina increases as you get older.

Variant angina is rare, but people who have variant angina often are younger than those who have other types of angina.

Angina may be linked to a type of air pollution called particle pollution. Particle pollution can include dust from roads, farms, dry riverbeds, construction sites, and mines.

Your work life can increase your risk of angina. Examples include work that limits your time available for sleep, involves high stress, requires long periods of sitting or standing, is noisy, or exposes you to potential hazards such as radiation.

Ischemic heart disease often runs in families. Also, people who have no lifestyle-related risk factors can develop ischemic heart disease. These factors suggest that genes are involved in ischemic heart disease and can influence a person’s risk of developing angina.

Variant angina has also been linked to specific DNA changes.

The more heart disease risk factors you have, the greater your risk of developing angina. The main lifestyle risk factors for angina include:

• Alcohol use, for variant angina
• Illegal drug use
• Lack of physical activity
• Smoking tobacco or long-term exposure to secondhand smoke
• Stress
• Unhealthy eating patterns

Medical conditions in which your heart needs more oxygen-rich blood than your body can supply increase your risk for angina. They include:

• Anemia
• A racing heart rate or blood vessel damage due to cocaine or methamphetamine use
• Cardiomyopathy, or disease of the heart muscle
• Damage to the heart caused by injury
• Heart failure
• Heart valve disease
• High blood pressure
• inflammation
• Insulin resistance or diabetes
• Low blood pressure
• Metabolic syndrome
• Overweight or obesity
• Unhealthy cholesterol levels

Heart procedures such as stent placement, percutaneous coronary intervention (PCI), or coronary artery bypass grafting (CABG) can trigger coronary spasms and angina. Although rare, noncardiac surgery can also trigger unstable angina or variant angina.

Some groups of people are at higher risk for developing ischemic heart disease and one of its main symptoms, angina. African Americans who have already had a heart attack are more likely than whites to develop angina.

Variant angina is more common among people living in Japan, especially men, than among people living in Western countries.

Angina affects both men and women, but at different ages based on men and women’s risk of developing ischemic heart disease. In men, ischemic heart disease risk starts to increase at age 45. Before age 55, women have a lower risk for heart disease than men. After age 55, the risk rises in both women and men. Women who have already had a heart attack are more likely to develop angina compared with men.

Microvascular angina most often begins in women around the time of menopause.