Which class of medication is primarily used to reduce heart rate during angina?

Beta-blockers are primarily used to reduce heart rate during episodes of angina. They work by blocking the action of adrenaline on beta-adrenergic receptors in the heart, which decreases heart rate and myocardial contractility. This reduction in heart rate decreases the oxygen demand of the heart muscle, helping to alleviate the symptoms of angina, which can result from inadequate blood flow to the heart muscle due to narrowed coronary arteries.

While calcium channel blockers also help in the management of angina by causing vasodilation and reducing the force of contraction, their primary function is not directly linked to heart rate reduction as effectively as beta-blockers. Nitrates primarily work by dilating blood vessels to reduce myocardial oxygen demand through decreased preload, rather than affecting the heart rate directly. Ranolazine, on the other hand, is a newer antianginal agent that works differently by modifying the metabolism of the heart and is not primarily focused on reducing heart rate.

Thus, beta-blockers stand out for their specific action in reducing heart rate, which plays a crucial role in the management of angina.