What are Nitrates?
The balance of tone of the coronary and peripheral circulation is dependent in a large part, on the generation of Nitric oxide, by the lining of blood vessels. In certain disease conditions, such as hypertension and heart failure, along with coronary artery disease, the generation of nitric oxide is inadequate. The main role of nitric oxide is to dilate the vessels.
Who might need Nitrates?
Angina: These drugs artificially releases nitric oxide in the blood stream and dilates the blood vessels, both of the coronary and peripheral circulation, directly and indirectly decreasing the workload of the heart and improving anginal symptoms.
Heart Failure: In certain individuals, such as those who have a low circulating renin level, they may also be beneficial when given on a regular basis.
There are limited nitrate tolerances and should really only be given in one dose a day, allowing a nitrate free period so the bodies sensitivity to the nitrate, generated nitric oxide, is not diminished. This is often why your cardiologist will use an agent such as Imdur, which is a very well designed sustained release preparation. When you first use it, it may cause headaches. These pass after a few days use.