The treatment of stable angina pectoris

A review of the available therapeutic measures for the management of stable angina pectoris is presented. The subject is critically examined by focusing on 5 main categories: general measures, drug therapy, coronary artery by-pass surgery, percutaneous transluminal coronary angioplasty and the handling of associated illnesses or disorders. General measures provide attention to the control or removal of aggravating conditions and to the institution of alterations in habits and life-style that will benefit the patient. Drug therapy depends upon the use of nitrates, beta adrenergic blockers and calcium entry blockers either alone or in combination. The mechanism of action of different drugs, its indications, as well as the dosage and frequency of use are reviewed. The indications for coronary artery by-pass surgery are presented as well as those for percutaneous transluminal angioplasty. An orientation in the selection of specific drugs when important concomitant diseases, such as hypertension and diabetes, coexist with stable angina pectoris is offered. The rationale behind the different alternatives is presented.