What agents can be used for prophylaxis against angina?

Long-acting nitrates, beta-blockers, and calcium channel blockers are all effective agents used for the prophylaxis of angina. Each class of these medications works through different mechanisms to alleviate or prevent angina symptoms.

Long-acting nitrates, such as isosorbide mononitrate, help to dilate blood vessels, improving blood flow to the heart and reducing the workload on the heart muscle. This results in less ischemia and decreased frequency of anginal episodes.

Beta-blockers reduce heart rate and myocardial oxygen demand by blocking the effects of adrenaline on the heart. This decreases the stress on the heart and mitigates the potential for angina.

Calcium channel blockers work by preventing calcium from entering the cells of the heart and blood vessels, which leads to relaxation of the vascular smooth muscle. This not only results in vasodilation but also decreases the force of contraction of the heart, thereby lowering myocardial oxygen demand.

The synergy of these three classes in treating angina enables a comprehensive approach to managing the condition, ensuring that patients can effectively prevent anginal episodes and maintain a better quality of life.