title: The risk of cardiovascular side effects with anti-anginal drugs.
abstract: Angina pectoris is a common presenting symptom of underlying coronary artery disease or reduced coronary flow reserve. Patients with angina have impaired quality of life; and need to be treated optimally with antianginal drugs to control symptoms and improve exercise performance. A wide range of antianginal medications are approved for the treatment of angina, and often more than one class of antianginal drugs are used to adequately control the symptoms. This expert opinion highlights the likely cardiac adverse effects of available antianginal drugs, and how to minimize these in individual patients and especially during combination treatment. Areas covered: All approved antianginal drugs, including the older and newly approved medications with different mechanism of action to the older drugs as well as some of the unapproved herbal medications. The safety profiles and potential cardiac side effects of these medications when used as monotherapy or as combination therapy are discussed and highlighted. Expert opinion: Because of the different cardiac safety profiles and possible side effects, we recommend selection of initial drug or adjustment of therapy based on the resting heart rate; blood pressure, hemodynamic status; and resting left ventricular function, concomitant medications and any associated comorbidities.
authors.affiliation: a Departmen of Medicine, Cardiovascular Section , The University of Oklahoma Health Sciences Center and the Veteran Affairs Medical Center , Oklahoma City , OK , USA.
authors.forename: Talla A
authors.initials: TA
authors.lastname: Rousan
authors.affiliation: a Departmen of Medicine, Cardiovascular Section , The University of Oklahoma Health Sciences Center and the Veteran Affairs Medical Center , Oklahoma City , OK , USA.
authors.forename: Sunil T
authors.initials: ST
authors.lastname: Mathew
authors.affiliation: a Departmen of Medicine, Cardiovascular Section , The University of Oklahoma Health Sciences Center and the Veteran Affairs Medical Center , Oklahoma City , OK , USA.
authors.forename: Udho
authors.initials: U
authors.lastname: Thadani
mesh_terms: D000787:Angina Pectoris / Q000188:drug therapy*; D000818:Animals; D001794:Blood Pressure / Q000502:physiology; D002317:Cardiovascular Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000139:chemically induced*; D004359:Drug Therapy, Combination; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D028321:Plant Preparations / Q000009:adverse effects / Q000627:therapeutic use; D011788:Quality of Life; D016277:Ventricular Function, Left / Q000502:physiology
chemical_list: D002317:Cardiovascular Agents; D028321:Plant Preparations
keywords: Angina pectoris; anti-anginal drugs; drug interactions; safety; side effects