Angina pectoris is chest pain due to poor functioning of arteries supplying the heart.
The New York Times’ Mark Bittman and Time Magazine’s Bryan Walsh may be telling us to eat butter, suggesting that dietary fat is not a problem, carbohydrates are the problem. But researchers in Spain said there is a …
Negative effect of a low-carbohydrate, high-protein, high-fat diet on small peripheral artery reactivity in patients with increased cardiovascular risk, British Journal of Nutrition, April 2013 (pdf)
This was a cross-sectional analysis of 247 men and women. Patients eating the least fat and the most carbohydrate (45% carb, 20% protein, 32% fat) had better small artery function than those eating the most fat and least carbohydrate (29% carb, 24% protein, 40% fat).
“Conclusion: In a cross-sectional study of patients with increased CV [cardiovascular disease] risk, a dietary pattern characterised by a high LCDS (high protein and fat, but low carbohydrate content) was associated with poorer peripheral small artery function compared with individuals consuming a diet with a lower LCDS. The association was strong in patients with two different metabolic diseases studied: the MS [Metabolic Syndrome] and T2D [Type 2 Diabetes].”
Fanatic Cook 
“When microvessels lose their ability to respond to the heart’s changing demands for oxygenated blood, chest pain and other symptoms can follow no matter how clean the larger coronary arteries are.”
– Big Trouble From Small Arteries
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I wondered to what extent the small artery reactive hyperaemia index (saRHI) is correlated with CV risk. I didn’t really find anything except this:
“… vascular reactivity tests. The most commonly used test of this nature is the assessment of flow-mediated dilation (FMD) of the brachial artery… . Another method, which is relatively new, focuses on small artery endothelial function and involves the determination of the small artery reactive hyperemia index. … It remains to be established whether vascular responses in the brachial artery and the small arteries of the finger are always related and whether these two measures are equally effective in predicting endothelial dysfunction.” (Michael Liebman, DOI: 10.1016/j.nut.2013.11.021)
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People with diabetes suffer microvascular complications resulting in retinopathy and amputations. I would think that discovery of a diet that improves microvascular function is a good thing.
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