Cholesterol is the cause
Both angina and heart attacks arise from a narrowing of the coronary arteries (the narrowing results from cholesterol deposits).

Cholesterol
Cholesterol is a vital body component. Most of the body's cholesterol is made in the liver with excess production occuring when the diet is rich in saturated (mainly animal) fats. There is a strong genetic omponent to cholesterol production, with high blood cholesterol production, with high blood cholesterol levels running in families.

Goodies and baddies
Not all cholesterol is potentially harmful. Only cholesterol carried by a blood transport system called low density lipoprotein (LDL) is potentially harmful (it is deposited into the walls of arteries). This is in contrast to cholesterol carried by high density lipoprotein (HDL) which acts to actually remove dangerous cholesterol in the wall of blood vessels.

Increased risk is even higher in the presence of other coronary risk factors (clustering) such as smoking, high blood pressure, being stressed, being well overweight and not exercising.

Cholesterol levels
Lowering "bad" LDL cholesterol (and increasing "good" HDL cholesterol) results in fewer deaths and heart attacks. This can be achieved through life style changes involving diets plus exercise or through therapeutic drug therapy prescribed by your GP.

High blood pressure
High blood pressure, or hypertension, is usually caused by an increased resistance in the small arteries of the body to the blood pumped out by the heart. In most cases the cause of the increased resistance is unknown. Blood pressure at the time of the heart's contraction is called systole and at the time of relaxation diastole. When blood pressure is measured, the higher number is reffered to as the "systolic" reading and the lower number the "diastolic" reading.

It rises upon wakening
Blood pressure (and heart rate) changes markedly over 24 hours. It is lowest during sleep and highest shortly after waking when most heart attacks occur; systolic blood pressure rises with increasing age.

Lowering blood pressure
Raised blood pressure can be lowered in two ways - life style changes or drug therapy. Life style changes that lower blood pressure (and heart rate) include weight reduction, avoidance of high salt foods, physical (aerobic) activity on a regular basis (most days of the week for about half-hour per session) and various anti-stress techniques.

Reduction of high alcohol intake to modest amounts also reduces blood pressure, therefore descreasing heart attacks and strokes. Dietary changes involving low salt, low animal fat and high fruit and vegetables intake lower raised blood pressure. Raised blood pressure that does not respond to life style changes can be lowered by various drugs prescribed by your GP.