[The choice of drugs and dosage for angina pectoris]

Nitrates, betablockers an calcium antagonists are the major drugs for treating angina pectoris. Therapeutic efficacy and incidence of unwanted reactions depend on the proper choice and dosage of these agents. The type of ischemic symptoms, cardiac function, presence of sinoatrial or atrioventricular conduction anomalies, and coexistent non-cardiac disorders should be taken into account when a particular drug is selected. In patients with angina at rest a calcium antagonist is indicated in the first place, while in exercise-induced ischemia betablockers and calcium antagonists are equally effective. With regard to antianginal efficacy there are no important differences between various representatives of these drug groups, but their tolerance may markedly vary in individual patients. Combination of betablockers, calcium antagonists and/or nitrates is often required in cases with severe limitation of exercise capacity. Therapeutic guidelines for patient groups with and without congestive heart failure are suggested.