Stable angina: management

Providing immediate relief from angina

You should be offered a short-acting nitrate drug called glyceryl trinitrate (GTN) to take if you get an attack of angina. You should also take it before you do something that usually brings on an attack, like physical activity, or going out when it is extremely cold. GTN comes as a spray or a tablet, to be sprayed or placed under the tongue. You may get a headache, flushing or dizziness soon after taking it. If you feel dizzy you should sit down or hold onto something until the feeling passes.

If the first dose doesn't work after 5 minutes, you should take another dose. If the pain has not gone away 5 minutes after taking the second dose, you should call an emergency ambulance.

Preventing future angina attacks

Your healthcare professional will usually offer you another drug to take every day to see whether it is effective in preventing your angina symptoms. This will usually be a drug called a beta blocker or a calcium channel blocker (see box below: 'Drugs for preventing symptoms of angina'). Your healthcare professional will check how you are getting on within two to four weeks of starting treatment, or if your treatment is changed. If your symptoms don't improve or you find the drug causes side effects which are a problem for you, your healthcare professional may change your dose of the drug, or offer you another type of drug instead or a combination of two drugs.

If you are still having symptoms with one or two drugs your healthcare professional will consider whether you need a procedure to help increase blood flow to your heart (see 'Procedures to improve blood flow to the heart'). If you are already waiting for a procedure to help increase blood flow to the heart, or such a procedure is not appropriate for you, your healthcare professional may consider a third drug for you to take.

Reducing your risk of cardiovascular disease

Your healthcare professional may also offer you drug treatment to help reduce your risk of cardiovascular disease. This might include 75 mg aspirin each day, unless there are reasons why you cannot take it. Aspirin makes your blood less 'sticky' and less likely to form blood clots. You should also be offered a statin, which is a type of drug to help lower your blood cholesterol, so fatty deposits are less likely to form in your blood vessels. If your blood pressure is high you should also be offered treatment to help lower it. If you have diabetes you may be offered a drug called an angiotensin-converting enzyme (ACE) inhibitor to help your stable angina. If you are already taking an ACE inhibitor for another condition, you should continue to take it.