When angina is caused by coronary artery disease, treatment usually includes:
Lifestyle changes — Changes include weight loss for obese patients, therapy to quit smoking, medications to lower high cholesterol, a program of regular exercise to lower high blood pressure, and stress reduction techniques.
Nitrates, including nitroglycerin — Nitrates are medications that widen blood vessels (vasodilators). They increase blood flow in the coronary arteries, and make it easier for the heart to pump blood to the rest of the body.
Statins, such as atorvastatin (Lipitor), rosuvastatin (Crestor) and simvastatin (Zocor, generic versions) - - These medications lower cholesterol, slow the rate of fatty buildup in the coronary arteries and decrease the risk of heart attack.
Beta-blockers, such as atenolol (Tenormin) and metoprolol (Lopressor, Toprol-XL) — These medications decrease the heart's workload by slowing the heart rate and reducing the force of the heart's contractions, especially during exercise.
Aspirin — Because aspirin helps to prevent blood clots from forming inside narrowed coronary arteries, it can reduce the risk of heart attacks in people who already have coronary artery disease.
Other commonly used drugs include:
Calcium channel blockers, such as nifedipine (Adalat, Procardia), verapamil (Calan, Isoptin, Verelan), diltiazem (Cardizem, Tiazac), amlodipine (Norvasc) — These medications may help to improve the efficiency of heart-muscle function and may decrease the number and severity of chest pain episodes.
Additional cholesterol lowering medications, such as niacin, fenofibrate, gemfibrozil and ezetimibe (Zetia). They can be used in combination with a statin or alone when a person has a very high triglyceride and/or very low HDL cholesterol.
If lifestyle changes and drugs fail to ease angina or when the risk of heart attack is great, your doctor may recommend balloon angioplasty or coronary artery bypass surgery.