An elderly friend told Huazi that he occasionally experienced chest tightness and pain when sleeping at night. He saw on the Internet that metoprolol can treat coronary heart disease. Can he use it to relieve the symptoms?

Huazi told him that metoprolol is not recommended. Although metoprolol can be used for coronary heart disease and reduce the frequency of angina pectoris, angina pectoris that occurs during rest at night may be variant angina pectoris, and the use of metoprolol drugs will make the situation worse. In his current condition, metoprolol drugs are not recommended, and he should seek medical attention as soon as possible.

1. What is variant angina

The function of the coronary artery is to supply blood and oxygen to the heart. When its lumen is narrowed , the heart will experience angina pectoris due to lack of blood and oxygen supply.

The common cause of coronary artery stenosis is atherosclerosis , where hardened plaques grow centripetally, restricting blood flow. When the degree of coronary artery stenosis exceeds 50%, coronary heart disease can be diagnosed. Angina pectoris occurs during strenuous activities, fatigue, and emotional excitement, and can be relieved after rest. It is also called stable angina pectoris (exertional angina pectoris).

Under certain factors, the coronary arteries may also experience spasm (strong contraction), leading to narrowing of the lumen and causing angina pectoris. It is not related to factors such as fatigue and emotions. It often occurs during rest or sleep , lasts longer, and the pain is more severe. It is called variant angina .

2. Lolamine and Angina Pectoris

Lolamine drugs are beta-blockers that can block beta receptors on the heart, slowing the heart rate, reducing myocardial contractility, reducing cardiac oxygen consumption, and effectively reducing the burden on the heart. They can be used to treat coronary heart disease and reduce the occurrence of angina pectoris.

However, when variant angina occurs, the use of loral drugs may cause problems. Because there are also beta receptors on the coronary arteries, when they are blocked by loral drugs, the effect of another type of alpha receptors will be relatively enhanced , and alpha receptors will cause vasoconstriction, making the original spasm of the coronary artery worse and worsening the condition.

Therefore, Lolamine drugs can be used to treat stable angina pectoris, but are not suitable for variant angina pectoris .

3. What to do if variant angina occurs

If you experience variant angina, you should seek medical attention as soon as possible , because this type of angina is more dangerous and may be a precursor to myocardial infarction , so it should not be taken lightly.

Calcium channel blockers (CCBs) can be used as drug options, including dipines (nifedipine, felodipine, amlodipine, benidipine, etc.) and non-dipines (diltiazem, verapamil, etc.), which can reduce the excitability of vascular smooth muscle cells, relieve spasms, and improve myocardial blood supply.

Nitrate drugs (nitroglycerin, isosorbide mononitrate, etc.) are also commonly used drugs that can increase the release of nitric oxide (NO) in blood vessels, activate corresponding receptors, dilate blood vessels, increase coronary blood flow, reduce cardiac load, and relieve angina symptoms.

4. Daily precautions for variant angina

People who have experienced variant angina should be careful not to overeat . It is enough to eat until you are 70% to 80% full at each meal. Reduce the intake of high-sugar, high-fat, high-cholesterol foods in your diet and control your weight and blood lipids . At the same time, you should strictly limit your daily salt intake to 3 to 5 grams , which is beneficial to blood pressure control and avoids water and sodium retention that increases the burden on the heart.

Increase the proportion of foods rich in dietary fiber, such as whole grains, vegetables, and fruits, to prevent constipation . When constipation occurs, you can use enema, laxatives and other drugs to assist defecation and avoid the cardiovascular risks caused by straining to defecate .

You can do moderate and gentle exercise, such as walking, Tai Chi, etc., but avoid overexertion .

In summary, Lol drugs can be used to treat stable angina pectoris, but are not recommended for variant angina pectoris that occurs during rest and sleep. If variant angina pectoris occurs, you need to see a doctor as soon as possible and use calcium channel blockers and nitrates for treatment under the guidance of a doctor.

If you have any questions about medication, please consult a doctor or pharmacist. I am pharmacist Huazi, welcome to follow me and share more health knowledge.