What is the pharmacological treatment for chronic stable angina?

Chronic stable angina is typically treated with a combination of therapies aimed at reducing myocardial oxygen demand and improving exercise tolerance. Among the pharmacological options, beta-blockers are considered a first-line treatment. They work primarily by decreasing heart rate and contractility, thereby lowering the amount of oxygen the heart muscle requires at rest and during exertion.

Beta-blockers are particularly effective in patients with exertional angina, as they help prevent angina episodes triggered by physical activity or emotional stress. By blocking the effects of catecholamines on the heart, these medications not only reduce the frequency of angina attacks but also improve overall exercise capacity. Additionally, they provide other cardiovascular benefits, such as reducing the risk of future cardiac events in patients with coronary artery disease.

While other options like calcium channel blockers and nitrates can also be used in the management of chronic stable angina, beta-blockers are uniquely effective in improving outcomes when it comes to angina relief and cardiovascular prognosis. ACE inhibitors are primarily indicated in patients with hypertension or heart failure and are not first-line for angina management.