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