Comparative Analysis of Beta-Blockers Versus Calcium Channel Blockers in the Management of Chronic Stable Angina

Background: Chronic stable angina is a common manifestation of coronary artery disease that significantly affects quality of life. Beta-blockers and calcium channel blockers are widely used for symptom control; however, their comparative effectiveness remains an area of clinical interest. Objective: This study aimed to compare the effectiveness of beta-blockers and calcium channel blockers in the management of chronic stable angina in terms of symptom control, exercise tolerance, and clinical outcomes. Methodology: This comparative observational study was conducted at the Department of Cardiology, Punjab Institute of Cardiology, Lahore, Pakistan, from June 2025 to December 2025, and included 260 patients diagnosed with chronic stable angina. Results: The mean age of the participants was 61.5 ± 9.3 years, with 148 (56.9%) males and 112 (43.1%) females. Beta-blockers achieved better heart rate control compared with calcium channel blockers (68.2 ± 7.5 bpm vs 74.6 ± 8.1 bpm, p < 0.001), with a greater proportion of patients achieving controlled heart rate (92 (70.8%) vs 54 (41.5%)). Patients receiving beta-blockers experienced fewer anginal episodes (2.1 ± 1.3 vs 2.8 ± 1.5, p = 0.002) and lower nitrate use (1.6 ± 1.1 vs 2.3 ± 1.4, p = 0.001). Exercise tolerance was also higher in the beta-blocker group (6.8 ± 1.4 metabolic equivalents (METs) vs 6.1 ± 1.6 METs, p = 0.003). Overall symptom improvement was greater with beta-blockers (72.5 ± 12.6% vs 65.3 ± 13.8%, p = 0.001), along with fewer hospital visits (1.4 ± 0.8 vs 1.9 ± 1.1, p = 0.002) and higher patient satisfaction scores (8.4 ± 1.1 vs 7.8 ± 1.3, p = 0.004). Conclusion: Beta-blockers demonstrated superior outcomes compared with calcium channel blockers in controlling symptoms and improving functional capacity in patients with chronic stable angina.