What is the first-line therapy for angina management in patients with a history of ischemic heart disease?

Beta-blockers are considered the first-line therapy for managing angina in patients with a history of ischemic heart disease due to their ability to effectively reduce myocardial oxygen demand. They achieve this by decreasing heart rate and contractility, which in turn lowers the workload on the heart. Additionally, beta-blockers have been shown to reduce the frequency of angina episodes and improve exercise tolerance, which is crucial for patients with ischemic heart disease.

The use of beta-blockers is particularly beneficial since they also provide cardioprotective effects, reducing the risk of recurrent cardiovascular events and mortality. They are recommended as a cornerstone for the secondary prevention of coronary artery disease, making them essential in the management of patients with a history of ischemic heart disease.

While calcium channel blockers and long-acting nitrates can also be effective for angina relief, they are typically used as adjunct therapies or in specific cases where beta-blockers are contraindicated or not tolerated. Antiplatelet agents are crucial for preventing thrombotic events but are not primarily focused on the management of angina itself. Instead, they serve to stabilize the condition and reduce the risk of acute coronary syndrome.