title: Treatment strategies for chronic stable angina.
abstract: BACKGROUND
  Stable angina pectoris - generally the expression of an imbalance between myocardial oxygen demand and supply - is often the first manifestation of ischemic heart disease. The effective management of this highly prevalent condition is largely dependent on the identification of the prevailing pathogenic mechanism, the implementation of lifestyle changes and the appropriate use of pharmacological agents and revascularization techniques. There is abundant literature on management of chronic stable angina, but publications are generally devoted to focused areas. There is a need for a comprehensive review that addresses both the different types of angina and their pathogenic mechanisms, as well as rational approaches to patient management.
  
  
  METHODS
  This paper reviews the pathogenesis and pathophysiological mechanisms of myocardial ischemia, along with its consequences and current treatment options. Relevant papers in the English literature were identified via PubMed, using the following keywords relating to chronic stable angina: ischemic heart disease, coronary artery disease and antianginal therapy.
  
  
  CONCLUSIONS
  The treatment of chronic stable angina has improved in recent years as a result of a better understanding of its pathogenic mechanisms, the implementation of lifestyle changes and aggressive management of risk factors, as well as pharmacological advances and better revascularization techniques. Understanding the pathogenesis of the disease is important to identify effective treatment strategies. A careful clinical history, the implementation of appropriate diagnostic tests and a rational use of antianginal drugs and revascularization protocols often ensure the successful control of the patient's symptoms.
authors.affiliation: St George's University of London, Cranmer Terrace, London SW17 0RE, UK. jkaski@sgul.ac.uk
authors.forename: Antonio
authors.initials: A
authors.lastname: Arrebola-Moreno
authors.forename: Jason
authors.initials: J
authors.lastname: Dungu
authors.forename: Juan-Carlos
authors.initials: JC
authors.lastname: Kaski
mesh_terms: D060050:Angina, Stable / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D054059:Coronary Occlusion / Q000150:complications / Q000378:metabolism / Q000517:prevention & control; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D008297:Male; D009200:Myocardial Contraction / Q000187:drug effects; D009204:Myocardial Revascularization; D010101:Oxygen Consumption / Q000187:drug effects; D012307:Risk Factors; D012737:Sex Factors; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000889:Anti-Arrhythmia Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D014665:Vasodilator Agents