Health Conditions

In 2002, the American College of Cardiology and the American Heart association published guidelines for treating angina that represented a consensus statement that was the result of numerous studies. Guidelines have also been published by organizations like the Agency for Health Care Policy and Research (AHCPR). All guidelines advocate a step approach, which includes lifestyle changes and the use of aspirin, nitrates, ACE inhibitors, beta blockers, and calcium antagonists. Drugs to lower cholesterol are also recommended if needed.

As in other heart diseases, the first step in treating angina is making lifestyle changes. These include smoking cessation, weight loss, regular exercise, eating a diet that is high in fiber and low in fat, and moderating one's alcohol consumption.

Then, if there are no contraindications, patients should be considered for daily aspirin therapy and nitroglycerin that is dissolved under the tongue when needed for angina attacks.

If patients require maintenance therapy to prevent angina attacks, then beta blockers are the preferred therapy due to their documented efficacy in post heart attack patients. If beta blockers are contraindicated or not tolerated, then long acting nitrates or calcium antagonists should be considered. Similarly, if beta blockers are tolerated, but the patient still experiences anginal episodes, then the addition of a long acting nitrate or a calcium channel antagonist should be investigated.

Most angina episodes are the result of partial blockage of coronary arteries resulting from plaque build-up. Because high levels of cholesterol play a role in this accumulation of arterial plaque, clinicians recommend lipid-lowering therapy for all patients with high cholesterol levels, and for high-risk patients who have elevated or normal cholesterol levels (see Treating Hypercholesterolemia).

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Note: The above information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist, or other healthcare professional. It is not intended to diagnose a health condition, but it can be used as a guide to help you decide if you should seek professional treatment or to help you learn more about your condition once it has been diagnosed.