You may have an increased risk for angina because of your age, environment or occupation, genetics, lifestyle, other medical conditions, race, or sex.

• Age

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.

• Environment or occupation

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 the 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.

• Family history and genetics

Ischemic heart disease frequently 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.

• Lifestyle habits

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. An inactive lifestyle contributes to high cholesterol, high blood pressure, type 2 diabetes, and obesity. However, it is important to talk with your doctor before starting an exercise program.

• Smoking tobacco or long-term exposure to secondhand smoke. Chewing tobacco, smoking and long-term exposure to secondhand smoke damage the interior walls of arteries, including arteries to your heart, allowing deposits of cholesterol to collect and block blood flow.

• Stress. Stress can increase the risk of angina and heart attacks. Too much stress, as well as anger, also can raise your blood pressure. Surges of hormones produced during stress can narrow your arteries and worsen angina.

• Unhealthy eating patterns

  Other medical conditions

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. Over time, high blood pressure damages arteries by accelerating the hardening of arteries;

• Inflammation;

• Insulin resistance or diabetes. Diabetes increases the risk of coronary artery disease, which leads to angina and heart attacks by speeding up atherosclerosis and increasing cholesterol levels;

• Low blood pressure;

• Metabolic syndrome;

• Overweight or obesity. Obesity is linked with high blood cholesterol levels, high blood pressure, and diabetes, all of which increase your risk of angina and heart disease. If you're overweight, your heart has to work harder to supply blood to the body;

• Unhealthy cholesterol levels. Cholesterol is a major part of the deposits that can narrow arteries throughout your body, including those that supply your heart. A high level of low-density lipoprotein (LDL) cholesterol, also known as "bad" cholesterol, increases your risk of angina and heart attacks. A high level of triglycerides, a type of blood fat related to your diet, also is unhealthy;

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

• Race or ethnicity. 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; 

• Sex. 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. Symptoms of angina in women can be different from angina symptoms that occur in men. These differences may lead to delays in seeking treatment. For example, chest pain is a common symptom in women with angina, but it may not be the only symptom or the most prevalent symptom for women. Women may also have symptoms such as:

• Nausea;

• Shortness of breath;

• Abdominal pain;

• Discomfort in the neck, jaw or back;

• Stabbing pain instead of chest pressure.

Men often feel pain in their chest, neck, and shoulders. Women may feel discomfort in their belly, neck, jaw, throat, or back. You may also have shortness of breath, sweating, or dizziness. One study found that women were more likely to use the words "pressing" or "crushing" to describe the feeling.