Your Good Health: Angina can progress to heart attack

Dear Dr. Donohue: I am 81. My last blood pressure reading was 140 over 78. I don’t take any medicines. When I do anything strenuous, I get angina. If I dream that I am doing something strenuous, like being chased or playing in a game, I wake up with angina. Why? My blood pressure is fine. — W.M.

Answer: Angina is chest pain on exertion. It comes on when the heart has to beat faster during exertion or during an emotional encounter, as in a dream. It’s due to a blockage of heart arteries that doesn’t permit an increased supply of blood to the heart muscle when it works harder. The blockage is a buildup of cholesterol, fat, blood proteins and blood platelets on the inner walls of the artery. High blood pressure is one, but not the sole, reason for such a buildup. High cholesterol, genes, diabetes, obesity and cigarette smoking are other, equally important factors. You should see a doctor pronto. Untreated angina can progress to a heart attack.

Coronary artery disease is one of the most common illnesses in North America. The booklet on that topic describes what happens and what can be done for it. Readers can obtain a copy by writing: Dr. Donohue — No. 101W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Canada.