In primary care, effectively managing a patient with stable angina involves providing clear information and support about the condition, including provoking factors, long-term course, and management strategies NICE CG126.
Encourage the patient to ask questions and address misconceptions about their angina, its implications, and treatment options NICE CG126.
Discuss lifestyle modifications such as exercise, smoking cessation, diet, and weight control, and assess the need for psychological support, offering interventions as necessary NICE CG126.
Prescribe sublingual glyceryl trinitrate for rapid relief of angina symptoms and instruct the patient on its use, including when to seek emergency help if symptoms persist NICE CG126.
Offer first-line regular treatment with a beta-blocker or a calcium-channel blocker, depending on comorbidities and patient preference, and review response after 2-4 weeks NICE CG126.
Advise on the use of a short-acting nitrate before planned exertion and instruct on its administration, side effects, and when to seek urgent care NICE CG126.
Consider secondary prevention medications such as aspirin 75 mg daily, ACE inhibitors for patients with diabetes, statins, and antihypertensives, tailored to individual risk factors NICE CG126.
Regularly review treatment response, side effects, and adherence, adjusting therapy as needed, and refer to a specialist if symptoms are poorly controlled or progressing NICE CG126.