Angina Treatment Options
If you've recently been diagnosed with angina, you and your doctor will be making some key treatment decisions together. The goal of angina treatment is straightforward: to reduce symptoms and slash the risk of heart attack. But treatment is often multi-tiered.
For example, everyone with angina will be told to take some smart lifestyle steps and will receive fast-acting nitrates—medication that can help in the event of an acute angina attack. And you will be treated quite differently for stable angina than for unstable angina.
But some of the decisions—for example, whether you stick with lifestyle and medication or move on to surgical procedures—will depend to a degree on your personal preferences. "Some people choose to have a procedure because they want quicker relief from angina symptoms," says Samin K. Sharma, M.D., director of cardiac catheterization at Mount Sinai Medical Center in New York City.
Keep in mind no procedure is a cure for heart disease. You'll continue taking medication and following a heart-healthy lifestyle whatever you choose.
Medication and lifestyle changes are best for everyone with angina. If you have chronic stable angina from a minor blockage, this may be all you need. As Roger Blumenthal, M.D., director of the Ciccarone Center for the Prevention of Heart Disease at Johns Hopkins Medicine in Baltimore explains. "Less severe blockages can be managed very successfully without an invasive procedure or major surgery."
These treatment measures can help patients with angina get their cholesterol, blood pressure, diabetes and other risk factors for coronary artery disease under control. "By following the ABC's for the management and prevention of heart disease, you can also prevent further plaque buildup in your arteries," says Dr. Blumenthal.
The second step is to tackle angina itself. For this, your doctor will prescribe fast-acting nitrates in sublingual tablets or spray form. These quickly widen arteries and restore blood flow during an angina episode.
Other medications, taken alone or in combination, can prevent angina pain from occurring in the first place. Long-acting nitrates, in capsules, skin patches and topical ointments, defend against angina by releasing nitroglycerin slowly into the bloodstream.
The blood pressure drugs known as beta-blockers, which slow your heart rate and reduce the amount of oxygen your heart needs, also prevent angina symptoms. Calcium channel blockers, which relax blood vessels to allow more blood to reach the heart, may be prescribed to head off angina symptoms as well.
A newer option for preventing angina in those with chronic angina is the medication ranolazine. It's not clear exactly how ranolazine keeps symptoms at bay, but it's a proven effective treatment for angina.
Success Rate of Medication and Lifestyle Changes to Treat Angina
About 90 percent of the millions of people currently living with stable angina can find relief with medication and lifestyle changes alone. This strategy might also help with unstable angina—but only temporarily. Severe angina symptoms call for treating your blockage directly.