Maarten Vasbinder lives in Isaan. His profession is general practitioner, a profession that he mainly practiced in Spain. On Thailandblog he answers questions from readers who live in Thailand and writes about medical facts.
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Dear Martin,
I have been living in Hua Hin since 2015. I am looking for advice regarding my angina pectoris, which I would like to treat with as little medication as possible, rather with an alternative/natural method.
Complaint: Angina Pectoris
Age: 68
Weight: 62 kg
Blood Pressure: 110/130 - 70/85
In 1992 with separation stress, first complaints of chest pain. In 2013, after neglected flu moisture on the heart, treated in hospital. Chest pain with heavier exertion, but this disappears within 1 minute.
Medications afterwards:
- Bisoprolol 2.5mg
- Aperine 81mg
Supplements:
- L-Arginine
- multivitamins
Further:
- No salt or sugar
- No meat
- 2 glasses of red wine with dinner
- Smoke 1 cigar per day (evening) with 1 small whiskey (4cl)
My question:
Can I also take Vitamin K 2? And is that useful? Is asperin 81 Mg necessary (I'd rather not)?
Regards,
C
******
Dear C,
Angina Pectoris (AP) is caused by the heart muscle demanding more oxygen than the coronary arteries can supply.
If this only happens during heavy exercise, then you speak of stable AP. If this also happens at rest, you speak of unstable AP, which is a dangerous condition that can lead to a heart attack.
In a real attack, a nitrate tablet under the tongue, or better a nitrate spray, helps. The latter lasts longer. The usefulness of a beta blocker such as bisoprolol is currently controversial. Ca-blockers, on the other hand, seem to work better for prevention. Examples: adalat (nifidipine) and amlodipine.
In 2013 you may have had a mild stroke. Was there any catheterization then?
As for natural/alternative methods, I have to disappoint you. Those don't work. Supplements do nothing here and if you eat healthy you don't need them. No salt, sugar and meat (especially organ meat contains a lot of vitamin K, precursor of K2) is allowed, although salt-free is not healthy either, at least according to the latest data. In the past, the salt pot was indeed the first to be banned.
Vit K2 has never been properly researched, except by the producer, who has to live on it. Research is currently being done elsewhere and there are indications, but no hard evidence, that it does something against arteriosclerosis.
In any case, there is enough in a healthy diet. If you still want to use extra, you can buy natto (fermented soy).
The usefulness of Aspirin is also controversial these days. There has been extensive publication on this in recent weeks. Taking Aspirin by healthy people for the prevention of cardiovascular disease does not seem very useful. However, this does not yet apply to people suffering from cardiovascular disease. So take it for the time being, for example after breakfast.
If it is possible to omit the cigar and drink one glass of wine instead of two glasses, you will benefit more than from jars full of supplements.
I also recommend that you have a check-up with a cardiologist.
Yours faithfully,
Martin Vasbinder