Nitrates in Cardiology

Overview

Nitrates have been applied in cardiology over one hundred years. They act via nitric oxide release. Nitric oxide isthe same substance as endogenous endothelium-derived relaxing factor (EDRF). The most frequently used nitratesare nitroglycerin, isosorbide dinitrate and isosorbide-5-mononitrate and similarly acting moledidomine. The widerange of actions results in antiischemic and antianginal effect. The inhibition of platelet a aggregation is importantas well. Nitrates have no significant adverse effects. They are used in symptomatic treatment of nearly all forms ofcoronary heart disease. They improve prognosis of patients with heart failure and have favourable effects on earlyand late left ventricle remodeling post myocardial infarction as well as on incidence of silent ischemia. Nitrates areused both for acute (short-term) and for long-term therapy. The may latter lead to development of tolerance, whichcan be prevented or reversed with intermittent-dosing regimens.

Key words:
nitrates, coronary heart disease, tolerance.