Other treatments that may be advised for angina
Other drugs to prevent angina pains
A beta-blocker (described above) may be sufficient to prevent angina pains. There are also other drugs that can be taken in addition, if required, to reduce the number and severity of angina pains. There are many drugs that can be used, but they fall into three main groups.
- Calcium channel blockers 'relax' the coronary arteries to increase blood flow. Some of these drugs also reduce the heart rate at rest, and the rate of rise in the heart rate when you exert yourself. So, less oxygen is needed by the heart.
- Nitrate drugs work in a similar way to GTN.
- Potassium channel blockers work in a similar way to nitrates.
There are several types and brands in each group. They are all good at preventing angina pains. If the pains are not well controlled by taking one drug, then another drug can be added from another group. As the different groups of drugs work in different ways, combinations of these drugs complement each other. It is quite common to take a 'combination therapy' of two or three drugs to prevent angina pains. The possible side-effects vary between the different drugs. Therefore, if a particular drug does not suit, you may find that a different one is fine. The aim is to find a drug, or combination of drugs, that prevent your pains, but with minimal side-effects.
Note: even when taking regular medication to prevent angina pains, you can still take GTN for 'breakthrough' angina pains that may still occur from time to time.
An angiotensin-converting enzyme (ACE) inhibitor drug
There are several types and brands of ACE inhibitors. These drugs prevent a build up of fluid by interfering with the enzyme angiotensin (a body chemical) which is involved in regulating body fluid. ACE inhibitors also have a protective effect on the heart, and may slow down the progression of heart failure. An ACE inhibitor is usually prescribed to people with angina who are shown to have a reduced function of the left ventricle of the heart or who have had a myocardial infarction (heart attack). In these situations, there is good evidence that in such people and ACE inhibitor improves prognosis (outlook).
However, it is uncertain whether an ACE inhibitor should be taken routinely by people with angina who do not have these other heart problems. Hopefully, research will clarify this issue. In the meantime, some doctors do prescribe an ACE inhibitor to all of their patients with angina.
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Where to next?
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Some other points about angina
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Understanding the arteries of the heart and causes of angina
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What are the aims of treatment if you have angina?
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What are the symptoms of angina?
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Imogen Crees, about 1 year
I am a nurse, but working in the community with children, so my heart knowledge is pretty dated! I found this article very helpful and reassuring. I had a ?MI last Thursday, thankfully it wasn't, and am awaiting a treadmill test for angina. As I am allergic to aspirin, I was given the other drug you mentioned, which I didn't know existed. Your article was clear and well explained, thank you.
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