Читать книгу Practical Cardiovascular Medicine - Elias B. Hanna - Страница 201

β-Blockers are first-line agents. If β-blockers are contraindicated because of bronchospasm, use a non-DHP; if β-blockers are contraindicated because of bradycardia, use a DHP. A long-acting nitrate or ranolazine is used as a second- or third-line agent. The combination DHP + nitrates may be used but is less favored, as both agents are vasodilators.

If one agent does not greatly relieve angina, use a combination of 2 to 4 agents (β-blocker + DHP +/- nitrate +/- ranolazine).

In HF patients with angina, β-blockers are started slowly. Nitrates may be added for angina or the combination of nitrates + hydralazine may be used for HF. DHP or ranolazine may be added if needed (amlodipine or felodipine may be slowly added, only if HF is compensated).