Angina Treatments

Symptoms of angina are usually attributable to atherosclerosis, which clogs coronary arteries with cholesterol plaques. The goal of angina treatment is to prevent atherosclerosis from worsening. In addition, treatment alleviates symptoms of angina and improves quality of life.

Lifestyle Changes: Smoking and Cholesterol Levels

Lifestyle changes, particularly dietary improvements, can slow the progression of atherosclerosis. Eating a healthy diet and limiting your cholesterol intake are a good way to start. Information on how to control cholesterol levels is available at Cholesterolfocus. Cholesterol medication lowers so-called “bad” cholesterol and increases “good” cholesterol, and is sometimes used to control angina.

Smoking impairs lung capacity and reduces the amount of oxygen available to the heart. Smoking has also been linked to a greater risk of developing atherosclerosis. If you smoke, quitting smoking is the best way to control atherosclerosis and angina symptoms. Of course, quitting smoking is easier said than done: ask your doctor about techniques and medications that help people stop smoking.

Nitrates: Quick Relief from Angina Symptoms

Nitrate medication, such as nitroglycerin, is the most common medication prescribed to control symptoms of angina. Short-term nitrates are available as tablets or spray, and are administered sublingually (under the tongue) for quick relief of symptoms of angina. Nitrates may be taken at the first sign of angina symptoms, or just before an activity known to trigger angina attacks.

Nitrate Dosing

Those taking long-acting nitrate medication must do so carefully. The amount taken, the interval between dosages and the length of time you take the medicine all vary according to your condition. While long-acting nitrates such as isosorbide-5-mononitrate can be taken regularly to control symptoms of angina, the medication requires intervals in which the body is nitrate-free or it loses its effectiveness. Patients taking long-acting nitrates must carefully follow their prescription guidelines.


Nitrates can interact with a long list of medications. Viagra, a medication used to treat male erectile dysfunction, cannot be used with nitrates. Viagra works by relaxing blood vessels in the penis. Nitrates work by a similar mechanism to relax blood vessels in other parts of the body. The combined effect of these drugs may be to cause too much blood vessel relaxation throughout the body, resulting in a limited supply of blood returning to the heart.

A report in the December 2003 European Heart Journal suggested Viagra may be safe for men with stable angina who are not taking nitrates, and may actually improve the results of angina exercise tests. Further research is needed to confirm these findings, and it bears repeating that Viagra should not be used with nitrate medications.

Low Dose Aspirin

Blood clots that are formed when atherosclerosis plaques rupture can obstruct coronary arteries and cause heart attacks. Aspirin is an antiplatelet medicine. By reducing the “stickiness” of platelets in the blood, aspirin lowers the likelihood of thrombosis (the formation of dangerous blood clots). As a result, people with symptoms of angina are sometimes prescribed low doses of aspirin.

A daily dose of aspirin (162 mg or less) is recommended as treatment for unstable angina. Aspirin, despite its availability over-the-counter, can cause a number of health risks. Use aspirin to treat angina or heart disease only on the advice of a doctor.

Beta Blockers and Other Vasodilators

Beta blockers, calcium channel blockers, and ACE inhibitors are sometimes used to treat symptoms of angina. By relaxing blood vessels and lowering blood pressure, these medications increase the amount of oxygen available to the heart.

Surgical Options

If atherosclerosis has advanced to the point that symptoms of angina progress or worsen, surgical intervention may be required. Bypass surgery and angioplasty are common heart attack treatments that may be used if symptoms of angina are severe.


National Heart, Lung, and Blood Institute. (nd). How is angina treated? Retrieved January 29, 2004, from

Radiology Society of North America. (updated 2003). Cardiac nuclear medicine. Retrieved February 2, 2004, from