Beta blockers to prevent angina
Beta blockers enhance exercise tolerance by reducing myocardial oxygen demand.
For patients with stable angina, beta blockers are usually first-line therapy to prevent episodes of angina, unless contraindicated. There is some evidence that beta blockers reduce incidence of recurrent myocardial infarction. To prevent episodes of angina with a beta blocker, use:
1atenolol 25 mg orally, daily, increasing if required up to 100 mg daily atenolol atenolol atenolol
OR
1metoprolol tartrate 25 mg orally, twice daily, increasing if required up to 100 mg 2 or 3 times daily. metoprolol metoprolol metoprolol
Do not use a beta blocker in combination with diltiazem or verapamil without specialist advice, because of the risk of severe bradycardia and heart failure.
For patients with left ventricular dysfunction (left ventricular ejection fraction 40% or less), use one of the beta blockers recommended for heart failure (carvedilol, bisoprolol, nebivolol or metoprolol succinate) instead of atenolol or metoprolol tartrate; see Beta blockers for HFrEF for dosage.