What is the most effective medicine for angina pectoris

  Angina pectoris is caused by myocardial ischemia, so drugs to improve myocardial ischemia can reduce the symptoms, but according to the specific circumstances of angina pectoris to choose targeted medication.  Clinically used drugs to reduce angina symptoms mainly include nitrates, beta-blockers and calcium channel blockers and other drugs.  1, nitrate drugs: nitrate drugs can dilate blood vessels, reduce myocardial oxygen consumption, improve myocardial perfusion, and relieve angina symptoms. Sublingual or spray nitroglycerin can be used to relieve symptoms of angina attacks, and can also be used a few minutes before exercise to reduce or avoid angina attacks. Long-acting nitrate drugs are used to reduce the frequency and degree of angina attacks and are suitable for chronic long-term treatment, such as isosorbide 5-mononitrate, isosorbide mononitrate extended-release preparation, etc.  2, β-blockers: β-blockers can slow down the heart rate, weaken myocardial contraction, reduce blood pressure, reduce myocardial oxygen consumption and angina attacks. At present, there are a variety of beta-blockers available for the treatment of angina pectoris, which can effectively prevent angina pectoris attacks when given in sufficient doses. Currently, there is a clinical preference for selective β1-blockers, such as metoprolol, atenolol and bisoprolol. However, beta blockers are prohibited in patients with severe bradycardia and high atrioventricular block, sinus node dysfunction, significant bronchospasm or bronchial asthma.  3, calcium channel blockers: through the improvement of coronary blood flow and reduce myocardial oxygen consumption to play a role in relieving angina pectoris. It can be divided into dihydropyridines and non-dihydropyridines. Dihydropyridine class clinically used drugs such as amlodipine, nifedipine, etc., non-dihydropyridine class clinically used drugs such as diltiazem. and verapamil. Calcium channel blockers are the first-line treatment for variant angina pectoris or angina pectoris with coronary artery spasm. Diltiazem? and verapamil slow down atrioventricular conduction and are often used in patients with angina pectoris with atrial fibrillation or atrial flutter. However, these two drugs should not be used in patients with severe bradycardia, high atrioventricular block and sick sinus node syndrome.  4, in addition to the above-mentioned drugs: at present, many Chinese herbal medicines and Chinese patent medicines that benefit qi, activate blood circulation and remove blood stasis, and aromatically open the orifices are also very effective in reducing the symptoms of angina pectoris and preventing angina attacks, and are a good choice for some patients who cannot tolerate the above-mentioned drugs.  5, in addition, angina patients also need long-term oral intake of the following drugs: anti-platelet aggregation drugs, commonly used in clinical aspirin, clopidogrel and Tegretol; statins, commonly used including atorvastatin, Rosuvastatin; improve myocardial remodeling drugs, commonly used including angiotensin converting enzyme class and angiotensin converting enzyme inhibitor class. All of these drugs can improve the prognosis of patients with angina pectoris, so they are recommended by clinical guidelines.  Angina is a serious class of cardiovascular disease symptoms, and the goal of drug therapy is to improve symptoms and prognosis. For each patient, specific decisions are made based on cardiac functional status, combined risk factors, etc. Patients must go to the hospital and use medications according to medical advice.