Stable angina : stepwise drug treatment based on NICE guidelines

The management of stable angina, a condition characterized by chest pain due to myocardial ischemia, is a critical aspect of cardiovascular care. The National Institute for Health and Care Excellence (NICE) guidelines provide a comprehensive framework for the pharmacological management of stable angina, emphasizing the importance of symptom relief, prevention of disease progression, and improvement of quality of life for patients. According to these guidelines, the initial pharmacotherapy typically includes beta-blockers, which are recognized as first-line agents due to their efficacy in reducing anginal symptoms and improving exercise tolerance (Rousan & Thadani, 2019; , Khera et al., 2014). Additionally, the use of long-acting nitrates and calcium channel blockers is recommended when beta-blockers are contraindicated or insufficient (Khera et al., 2014).

The guidelines also underscore the significance of risk factor modification, including the use of antiplatelet agents like aspirin and lipid-lowering medications such as statins, which play a vital role in reducing cardiovascular events and improving patient outcomes (Rousan & Thadani, 2019; , Rousan et al., 2017). Recent advancements in pharmacotherapy have introduced agents like ranolazine and ivabradine, which offer alternative mechanisms of action for patients who do not achieve adequate symptom control with traditional therapies (Luca et...