Drugs to Treat Angina Pectoris
The two major classes of drugs used to treat angina are nitrates and beta blockers. Nitrates come
in several forms: as nitroglycerin or other tablets that may be slipped under the tongue to bring
relief during an attack, as an ointment to be absorbed through the skin to prevent or relieve an
attack, as long-acting tablets or capsules to be taken orally to prevent an attack. Recently, still
another form--a disc to be applied to the skin to provide a steady release of the drug over a period
of several hours--has become available.
Beta-blocking drugs help prevent angina attacks by slowing the rate at which the heart beats,
thereby reducing the heart's workload and lowering the amount of oxygen it needs. These drugs should
be taken exactly as instructed, and should not be stopped abruptly.
A new class of anti-anginal drugs known as calcium-blocking agents appears to be particularly effective
in controlling the type of angina associated with coronary spasm. All muscles require varying amounts
of calcium in order to constrict; by reducing the amount of calcium that enters the muscle cells in
the coronary vessel walls, the spasms that choke off the heart's blood supply may be prevented.
Surgical Treatment
In some patients, coronary bypass surgery may be recommended. This operation entails taking a portion
of a vein, usually from the leg, and grafting it to the coronary artery to bypass the clogged area.
Many factors are considered in deciding whether or not to operate, including the extent of coronary
disease, degree of disability from the angina, and the age and general physical condition of the patient.
Summing Up
Angina is a common manifestation of a progressive narrowing of the coronary blood vessels. It also may
be caused by a temporary spasm of these vessels. Most angina patients can be effectively treated through
a combination of life-style changes and drugs. No one treatment works for all patients; each person must
be evaluated by his or her doctor, who can then prescribe the most effective treatment.
