In their excellent article, “Physiologic Approach to the Treatment of Angina Pectoris” (N.E.J.M. 281: 1225–1228, 1969) Mason and his associates discuss nitrites, beta-adrenergic receptor blocking agents and carotid-sinus nerve stimulation as means of lessening myocardial oxygen demand and thus reducing anginal pain. Another most physiologic form of therapy that probably has the same effect is controlled, well prescribed exercise. Angina usually occurs at the same blood pressure and pulse multiple (systolic-tension-time index) for each patient.1 As the authors discuss, blood pressure and heart rate are among the determinants of myocardial oxygen consumption. Hellerstein,2 Clausen et al.3 and….
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