What class of drugs is considered first line for chronic angina treatment?

The first-line treatment for chronic angina is beta blockers. These medications work by decreasing the heart rate and reducing myocardial oxygen demand, which can alleviate the symptoms of angina. They contribute to improving exercise tolerance and reducing the frequency of anginal episodes.

Beta blockers are particularly beneficial because they not only relieve angina symptoms but also address underlying conditions such as hypertension and are protective against future cardiovascular events. They are recommended for patients with stable angina and those who have a history of myocardial infarction, making them a versatile choice in the management of chronic angina.

Calcium channel blockers, nitrates, and ACE inhibitors do play roles in the treatment of angina, but they are generally not considered first-line therapies for the chronic management of stable angina. Calcium channel blockers can be useful, especially in patients who have contraindications to beta blockers, while nitrates are often used for immediate relief during an angina attack rather than as continuous therapy. ACE inhibitors, while important in managing blood pressure and heart failure, do not directly relieve angina symptoms in the same manner that beta blockers do.