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DRUGS FOR ANGINA: BETA-BLOCKERS
Research demonstrates that beta-blockers are considered first-line therapy in most patients with chronic angina and prolong life in patients who have had a heart attack.
Beta-blockers prevent angina by lowering the oxygen needs of the heart during physical exertion or emotional stress. They do this by reducing the heart rate, the force of heart muscle contraction, and blood pressure. Your heart rate may fall as low as fifty beats per minute, and if you feel well at that rate, the medicine is acting just as it should.
In the U.S., propranolol (Inderal), atenolol (Tenormin), and nadolol (Corgard) are the most frequently used beta-blockers for angina. They are not used for Prinzmetal’s angina because they tend to increase spasm when it is the cause of angina rather than lessen it.
Patients with asthma, Chronic Obstructive Pulmonary Disease (COPD), diabetes, heart failure, or depression need special evaluation before they use beta-blockers. Symptoms can be exacerbated on these drugs. Even without such coexisting conditions some people find beta-blockers hard to tolerate. They may experience side effects such as impotence, bad dreams, cold hands and feet, and fatigue. If you decide beta-blockers are not for you despite their proven effectiveness, do not stop taking them abruptly. You might get “rebound angina.” Talk it over with your doctor, who will decide what is best for you.
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