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What lifestyle modifications should I advise to a patient with stable angina to improve their condition?
Answer
Advise the patient to undertake regular physical activity sufficient to increase exercise capacity, starting at a comfortable level and gradually increasing duration and intensity, aiming for 20 to 30 minutes a day to the point of slight breathlessness.
Encourage the patient to limit their alcohol intake to 14 units a week, spread over at least 3 days, to reduce cardiovascular risk.
Support smoking cessation efforts, as stopping smoking is essential for reducing cardiovascular risk.
Recommend a Mediterranean-style diet, rich in bread, fruit, vegetables, and fish, and low in meat, with reduced intake of butter and cheese based on plant oils.
Advise the patient to maintain a healthy weight, with support for weight management if overweight or obese.
Discuss the importance of managing comorbid conditions such as hypertension, diabetes, and hyperlipidemia, in line with NICE guidelines.
Instruct the patient on the proper use of short-acting nitrates for symptom relief and to seek medical help if symptoms worsen or do not resolve after medication.
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