How can I effectively manage a patient with stable angina in a primary care environment?

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 ¹.

Encourage the patient to ask questions and address misconceptions about their angina, its implications, and treatment options ¹.

Discuss lifestyle modifications such as exercise, smoking cessation, diet, and weight control, and assess the need for psychological support, offering interventions as necessary ¹.

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 ¹.

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 ¹.

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 ¹.

Consider secondary prevention medications such as aspirin 75 mg daily, ACE inhibitors for patients with diabetes, statins, and antihypertensives, tailored to individual risk factors ¹.

Regularly review treatment response, side effects, and adherence, adjusting therapy as needed, and refer to a specialist if symptoms are poorly controlled or progressing ¹.