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Zestoretic (Hydrochlorothiazide, Lisinopril)

The walls of normal coronary arteries are smooth, clean and elastic. This allows them to contract and expand to give more oxygen and blood to the heart when it is required, to cope with any extra demand. This extra demand may come from a number of sources: for example, when the body is working harder, climbing a hill, running for a bus, doing strenuous housework; when the body is under stress or fighting an infection; when we have to deal with excessive emotion, for example, rage, fear, anxiety; or when the vessels themselves cause problems, as in coronary spasm, then the heart receives extra electrical stimulation via the nerves to make it pump more blood around the body. In order to do this the coronary arteries have to supply more blood and oxygen to the heart itself.
The healthy heart can cope with these extra demands. However, coronary disease results in the lining of the arteries becoming thicker, therefore narrower in diameter, and less elastic. This means that when extra demand is placed on the heart, the coronary arteries cannot respond effectively and not enough oxygen gets through. This is known as the oxygen deficit.
When people become familiar with their angina, they learn what events trigger off the pain. Some of the most common triggers are:
Smoking, physical exertion: Running, lifting and carrying heavy loads – especially first thing in the morning or after a heavy meal – walking in cold winds or very hot climates. Stress: Anger, anxiety, fright, arguments, talking in public or complaining about a purchase.
These triggers are very individual and some people will respond more to the physical triggers than the psychological ones and vice versa.

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