Selection of optimal drug therapy for the patient with angina pectoris

The development of new drugs, especially beta-blocking and calcium entry-blocking agents, has greatly facilitated the medical treatment of angina pectoris. The specific needs of each patient should dictate the appropriate treatment of angina pectoris. Angina may occur in patients who have various concomitant disorders such as hypertension, diabetes mellitus, peripheral vascular disease, chronic obstructive pulmonary disease, or arrhythmias, and the physician must take these factors into account when a drug regimen is prescribed. Individual drugs should be chosen on the basis of specifically desired pharmacologic effects, and the dosages should be gradually adjusted according to the patient's response. Although a therapeutic regimen should be selected primarily on the basis of efficacy, the physician must also attempt to recommend a simple and cost-effective program.