Stable Angina Pectoris: A Review of Pathophysiology, Diagnosis, and Its Management

Abstract

India is at the cusp of an impending epidemic of cardiovascular diseases (CVD). It has been triggered by rapid urbanization, industrialization, and globalization. Coronary artery disease (CAD) and ischemic heart disease (IHD) clinically present as angina pectoris (chest pain and discomfort). Despite advances in treatment options for CAD, a lack of awareness of risk factors and disease, access to healthcare, and affordability are the primary concerns in low- and middle-income countries. In India, CAD results in >7 million deaths annually. There is a need for active collaboration between patients, physicians, and healthcare providers to identify the early and adequate use of lifestyle, pharmacological, and primary and secondary preventive measures. Antianginal treatment options are categorized as first line (calcium channel blockers (CCBs), β-blockers, and short-acting nitrates) and second line (ivabradine, nicorandil, ranolazine, and trimetazidine) drugs. This review discusses different CCBs (dihydropyridines (DHPs) or nondihydropyridines) for the management of angina pectoris.