For a patient with chronic stable angina and a history of CAD, which intervention would provide the most benefit?

Adding amlodipine 5 mg daily for a patient with chronic stable angina and a history of coronary artery disease (CAD) is a beneficial intervention primarily due to its vasodilatory effects and ability to reduce myocardial oxygen demand. Amlodipine is a calcium channel blocker that helps to relieve anginal symptoms by decreasing peripheral vascular resistance and thereby reducing afterload on the heart. This mechanism is particularly beneficial for patients with chronic stable angina, as it leads to improved exercise tolerance and can help prevent anginal episodes.

In the context of managing chronic stable angina, calcium channel blockers like amlodipine can also complement the effects of beta-blockers, such as metoprolol, by providing additional anti-anginal protection without significant adverse cardiovascular effects. They are particularly useful in cases where detailed titration of beta-blockers is insufficient for controlling symptoms.

In contrast, while other interventions such as diltiazem and isosorbide mononitrate can also be useful in treating angina, they may not be as effective as amlodipine for this particular patient's needs. Diltiazem is another calcium channel blocker that can be beneficial, but it may also have a negative chronotropic effect, which can be less desirable