What are the medical treatments for angina pectoris considered as first line for chronic management?

Beta-blockers are considered first-line therapy for the chronic management of angina pectoris primarily because they effectively reduce myocardial oxygen demand by decreasing heart rate, contractility, and blood pressure. This is particularly beneficial in patients with stable angina, where the typical goal is to prevent angina episodes and improve exercise tolerance.

In the context of angina, beta-blockers help alleviate symptoms by blocking the effects of catecholamines, which can increase heart workload. Additionally, they have been shown to improve outcomes in patients with coronary artery disease by reducing the risk of myocardial infarction and improving survival rates.

While calcium channel blockers, nitrates, and aspirin also play important roles in managing angina, they are typically not the first line. Calcium channel blockers can be useful, especially in patients who cannot tolerate beta-blockers, but they tend to be considered second-line. Nitrates are effective for immediate relief of angina symptoms but are primarily utilized for acute episodes and not as a long-term solution due to tolerance issues. Aspirin, on the other hand, serves as an antiplatelet agent and is essential for reducing cardiovascular events but does not directly address the ischemic symptoms of angina.

In summary, beta-blockers are preferred for