Organic nitrates stable angina

Organic nitrates (and nitrites) are simple nitric and nitrous acid esters of alcohols. They differ in their volatility for example, isosorbide dinitrate is solid at room temperature, nitroglycerin is only moderately volatile, whereas amyl nitrate is extremely volatile. These compounds cause a rapid reduction in myocardial oxygen demand followed by rapid relief of symptoms. They are effective in stable and unstable angina, as well as Prinzmetal s or variant angina pectoris. 

Mechanism of Relief of Symptoms of Angina Pectoris The nitrate-induced relief of anginal pain has been ascribed to a decrease in cardiac work secondary to the fall in systemic arterial pres-sine. The ability of nitrates to dilate epicardial coronary arteries is modest the bulk of evidence favors a reduction in myocardial work and thus in myocardial oxygen demand as their primary effect in chronic stable angina. Paradoxically, high doses of organic nitrates may reduce blood pres-sine to such an extent that coronary flow is compromised reflex tachycardia and adrenergic... 

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