Chronic Angina Pectoris: Inadequacies of Current Therapy
Chronic Angina Pectoris: Inadequacies of Current Therapy
Chronic angina is a major medical problem in the United States with more than 6 million patients affected, a number that will increase substantially because of the progressive aging of the population. The annual mortality rate for patients with chronic angina is approximately 2%, but is much higher in certain subsets of patients, particularly the elderly. Angina is also associated with major social and economic burdens. Because of poor symptom control and hemodynamic, as well as other drug side effects, angina is commonly associated with a poor quality of life. No new class of drug has been available for angina treatment in more than two decades, and current medications frequently fail to provide adequate symptom control. Thus, the majority of patients are taking two or three antianginal medications. New agents that modulate myocardial metabolism have shown antianginal efficacy, a favorable side-effect profile, and an absence of hemodynamic effects.
Ischemic heart disease is the leading cause of death and morbidity in the United States, with a mortality rate higher than that of all cancers combined. Angina pectoris affects more than 6 million Americans, with approximately 400,000 new cases diagnosed annually. Its prevalence has increased progressively because of the increasing population over the age of 65 years. This is the fastest growing segment of the population and is expected to double by 2030. Each year, more than 1 million patients experience myocardial infarction, and many more are hospitalized with chest pain syndromes. Angina is a clear warning sign of a potential myocardial infarction; approximately 50% of myocardial infarction patients have had preceding angina.
The traditional image of angina has been that it primarily affects middle-aged men, but more recent information has documented that this notion is erroneous because the majority of patients with angina pectoris today are women. The overall annual mortality rate associated with angina is approximately 2%, but is much higher in certain subsets, particularly the elderly. It is noteworthy that the mortality rate among postmenopausal women is similar to that of men. Thus, angina is a major problem in an aging population for both men and women.
This review discusses the medical, social, and economic burdens associated with angina pectoris, as well as current treatment options and the inadequacies of current medical therapy. We also address the question of patients' quality of life (QOL), the importance of communication between physician and patient, and the need for new and more effective medical treatments.
Chronic angina is a major medical problem in the United States with more than 6 million patients affected, a number that will increase substantially because of the progressive aging of the population. The annual mortality rate for patients with chronic angina is approximately 2%, but is much higher in certain subsets of patients, particularly the elderly. Angina is also associated with major social and economic burdens. Because of poor symptom control and hemodynamic, as well as other drug side effects, angina is commonly associated with a poor quality of life. No new class of drug has been available for angina treatment in more than two decades, and current medications frequently fail to provide adequate symptom control. Thus, the majority of patients are taking two or three antianginal medications. New agents that modulate myocardial metabolism have shown antianginal efficacy, a favorable side-effect profile, and an absence of hemodynamic effects.
Ischemic heart disease is the leading cause of death and morbidity in the United States, with a mortality rate higher than that of all cancers combined. Angina pectoris affects more than 6 million Americans, with approximately 400,000 new cases diagnosed annually. Its prevalence has increased progressively because of the increasing population over the age of 65 years. This is the fastest growing segment of the population and is expected to double by 2030. Each year, more than 1 million patients experience myocardial infarction, and many more are hospitalized with chest pain syndromes. Angina is a clear warning sign of a potential myocardial infarction; approximately 50% of myocardial infarction patients have had preceding angina.
The traditional image of angina has been that it primarily affects middle-aged men, but more recent information has documented that this notion is erroneous because the majority of patients with angina pectoris today are women. The overall annual mortality rate associated with angina is approximately 2%, but is much higher in certain subsets, particularly the elderly. It is noteworthy that the mortality rate among postmenopausal women is similar to that of men. Thus, angina is a major problem in an aging population for both men and women.
This review discusses the medical, social, and economic burdens associated with angina pectoris, as well as current treatment options and the inadequacies of current medical therapy. We also address the question of patients' quality of life (QOL), the importance of communication between physician and patient, and the need for new and more effective medical treatments.
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