2) Medications
As mentioned before, treatment is decided based on severity. In the case of stable angina, lifestyle changes and medications are usually sufficient to control the condition. These medications include:
A. Medications used during the attack (nitrates)
These dilate the coronary arteries supplying the heart muscle and therefore, increase the blood supply to the heart, relieving the attack within minutes. You should never self-medicate with nitroglycerin or other nitrates without consulting your treating physician, especially if you are using other medications for erectile dysfunction as Sildenafil (Viagra) or Tadalafil (Cialis), or if you are liable to hypotension.
B. Medications that lower blood pressure
They include ACE inhibitors and calcium channel blockers. They lower blood pressure by vasodilation (increasing the diameter of blood vessels) and the work the heart has to do to overcome such pressure, decreasing its oxygen demand and the incidence of angina. Calcium channel blockers also dilate the coronary arteries thus increasing the heart’s blood supply.
C. Beta-blockers
These medications decrease the heart rate and reduce the oxygen demand by the heart. They also prolong the time it takes for coronary arteries to fill, improving the blood supply to the heart.
D. Medications that lower blood cholesterol
The most commonly used class is statins, such as atorvastatin and simvastatin. They decrease the formation of cholesterol in the body, decrease its absorption, and help reabsorb cholesterol that’s been already deposited in the coronaries and other blood vessels, reversing the pathology.
E. Aspirin and other antiplatelets
These medications may be also prescribed by your doctor. They act by preventing your platelets from “sticking together” quickly and thus, decreasing the risk of blood clots.
F. Ranolazine
Ranolazine is a relatively novel drug used either as a substitute or complementary to beta-blockers and ACE inhibitors. It reduces the heart’s need for oxygen making the diminished blood supply more tolerable, thus preventing heart attacks.
