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How should angina be managed?1,2

The management of angina pectoris is based on 2 approaches: the treatment of the painful attack and the long-term treatment.

The objectives are to

  • Restore, if possible, a good blood flow to the heart.
  • Manage the symptoms.
  • Prevent angina attacks.
Avoid complications such as
myocardial infarction
or heart failure (to learn more about heart failure, click here).
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of patients don’t have an adequate treatment.3

Only 25%

of patients who reported angina in the prior month have their treatment escalated at the end of their visit.4

Why do I need an acute treatment?1,2

GoalTo treat the angina attack and the associated pain.
When?When you may experience chest discomfort or before a potential trigger (exercise, emotional stress, heavy meal etc).
How?By taking specific medicines: short-acting nitrates in the form of tablets that you put under your tongue or mouth spray.
Why?It will relax and widen your blood vessels increasing your blood flow and restoring a good blow flow to your heart.

Why do I need a long-term treatment?1,2

GoalTo treat the angina attack and the associated pain.
When?Daily, as angina is a chronic symptom and therefore a long-term treatment is needed.
How?By a multifaceted approach including medicines, lifestyle changes, sometimes medical procedures and surgery if needed and by knowing your triggers.


To get angina under control and prevent angina attacks, your doctor might prescribe more than 1 medicine to be taken every day.
Medicines to reduce angina symptomsMedicines to prevent blood clots
Long-acting nitratesAspirin
Calcium-channel blockersOther clot preventing drugs (Clopidogrel, Ticagrelor etc)
If you have any doubts or questions about your treatment for angina or any other condition, talk to your doctor.

Lifestyle changes1

To live with angina and reduce the risk of having further problems in the future, it is not only about managing symptoms. You have an important role to play, particularly by changing your lifestyle to include doing regular exercise, quitting smoking, managing your stress, monitoring your blood pressure, improving your diet, and moderating alcohol consumption.

Start doing regular physical activity7

  • To reduce your blood pressure.
  • To reduce your stress levels.
  • To manage your weight.
  • To improve your cholesterol levels.
  • To improve blood sugar levels.

Before starting any exercise, ask your doctor’s permission and make sure to talk to your doctor on a regular basis so you can exercise in a way that is right for you. It is important to start slowly and not to overexert yourself.

`If you experience any chest pain, STOP whatever you are doing and follow your doctor's advice!`

Quit smoking10,11,12

  • Your heart rate and blood pressure will improve in just 20 minutes.
  • Your sense of smell and taste will improve in 2-3 days.
  • You will find it easier to breathe and exercise in 2-12 weeks.
  • Lower your risk of a heart attack by 50% in 1 year.
You could write a book about the benefits of quitting smoking!

Improve your diet

  • To improve your cholesterol levels.
  • To improve blood suger levels.
  • To reduce your blood pressure.
  • To manage your weight.

Manage your stress7

  • To reduce your blood pressure.
  • To reduce behavior that will incease your blood pressure (poor diet, physical inactivity, smoking, alcohol, etc).

Monitor your blood pressure7

  • To preserve your heart and your blood vessels.
  • To reduce the risk of fatty deposits on your vessels.
  • To reduce your risk of a heart attack and premature death.

Find more about Heart rate19,20,21

  • It is the number of times the heart beats within a certain time period, usually a​ minute. The heart rate can be felt at the wrist, side of the neck, back of the knees, top of the foot, groin, and other places in the body where an artery is close to the skin. ​Measuring the heart rate gives important information about a person’s health. ​Also called pulse.”

Talk with your doctor about how to measure your heart rate, how often, and how to interpret your results.

Medical procedures and surgery1
Medical procedures and surgery may be considered if needed. If you would like more information on this treatment approach, don’t hesitate to talk to your doctor.
Know your triggers1
As most episodes of angina follow a pattern, try to know and to track your possible triggers (exercise, emotional stress etc) to manage episodes of angina.
Show references


Kureshi F et al. Clin Cardiol. 2017;40(1):6-10.
Qintar M et al. Eur Heart J Qual Care Clin Outcomes. 2016;2(3):208-214
Ferrari R. Nat Rev Cardiol. 2018;15(2):120-132.
Knuuti Jet al. Eur Heart J. 2020;41(3):407-477.
Letnes JM et al. Eur Heart J. 2019;40(20):1633-1639.
Gopinath B et al. Sci Rep. 2018;8(1):10522.
Gometz ED. Virtual mentor. 2011;13(1):31-35.
Tindle HA et al. J Natl Cancer Inst. 2018;110(11):1201-1207.
Pollock RL. JRSM Cardiovasc Dis. 2016;5:1-9.
Hooper L et al. Cochrane Database Syst Rev. 2015;10(6):CD011737.
Schneider RH et al. Circ Cardiovasc Qual Outcomes. 2012;5(6):750-758.​
Jespersen L et al. Clin Res Cardiol. 2013;102(8):571-581.
Jespersen L et al. Eur Heart J. 2013;34(42):3294-3303.
Kaski JC et al. Open Heart. 2018;5(1):e000725.