The role of nitrates, beta blockers, and calcium antagonists in stable angina pectoris.
Numerous controlled studies have shown that nitrates, beta blockers, and calcium antagonists are effective in the treatment of stable angina pectoris. The pharmacokinetics, pharmacodynamics, and hemodynamic effects of these agents are different, and thus combination therapy offers additive improvement and also counterbalancing of the undesirable side effects of each drug. The choice of therapy depends on the severity of symptoms, associated diseases, compliance, side effects, and status of left ventricular function. The main mechanism of improvement is a decrease in myocardial oxygen consumption, though an increase in coronary blood flow is another potential reason for the use of calcium blockers. This review considers the properties of these drugs, their mechanism of action, and the results of randomized studies.
D000318:Adrenergic beta-Agonists / Q000627:therapeutic use*; D000787:Angina Pectoris / Q000188:drug therapy*; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004361:Drug Tolerance; D006801:Humans; D009566:Nitrates / Q000378:metabolism / Q000627:therapeutic use*
D000318:Adrenergic beta-Agonists; D002121:Calcium Channel Blockers; D009566:Nitrates