In a patient with chronic stable angina, what adjustment should be made to improve angina symptoms?

Increasing the dosage of metoprolol to 50 mg taken twice daily is a valid strategy for improving symptoms of chronic stable angina. Metoprolol, a beta-blocker, is widely used in the management of angina because it reduces myocardial oxygen demand by decreasing heart rate, contractility, and blood pressure during physical activity or stress. In patients with chronic stable angina, the goal is to enhance exercise tolerance and decrease the frequency and severity of angina episodes.

When a higher dose of metoprolol is administered, it may provide additional benefits for patients who are still experiencing angina symptoms despite being on a lower dose. This incremental approach helps optimize heart rate control and overall cardiac workload, which are critical in managing chronic stable angina.

Adding medications like nitrates or other agents may offer adjunctive relief, but increasing the dose of a cornerstone therapy like metoprolol can have a more direct impact on angina-related symptoms in this specific patient population.