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After identifying the underlying cause of angina (chest discomfort) with no blockage, also known as ischemia with no obstructive coronary artery disease (INOCA), specialists at NYU Langone Heart create a tailored treatment plan that may include certain prescription medications to reduce symptoms and to help prevent future problems. These medications treat the large and small arteries to help them provide blood flow in response to the body’s demands.
Certain medications, such as calcium channel blockers and long-acting nitrates, help to reduce the risk of coronary artery spasm and promote better blood flow to your heart. These are the main treatments needed when there is coronary artery spasm.
Beta blockers like atenolol or propranolol may be used to slow the heart rate, relieve high blood pressure, and lessen the oxygen demand on the heart.
These drugs, such as lisinopril, enalapril, and ramipril, help relax and widen your blood vessels, which makes it easier for your heart to pump blood. Angiotensin-converting-enzyme (ACE) inhibitors work by blocking the production of a hormone that can constrict blood vessels. Observational research suggests ACE inhibitors may lower risk for further heart events after angina with no blockage.
Angiotensin II receptor blockers (ARBs), such as losartan, valsartan, and candesartan, have many of the beneficial effects of ACE inhibitors, but they work in a slightly different way by blocking the action of a hormone that can constrict blood vessels. Observational research suggests ARBs may lower cardiovascular risk after angina with no blockage, making them an alternative to ACE inhibitors.
Statins and other medications can lower blood cholesterol levels, which makes any plaque more stable and less likely to cause heart attack or stroke. If cholesterol levels get very low, plaque might even start to dissolve.
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