What are nitrates?
Nitrates are medications used for treating or preventing chest pain (angina) caused by heart disease, usually of the arteries in the heart. Nitrates are vasodilators (dilators of blood vessels that increase their diameter) that allow blood to flow more easily. Blood returning from the body in the veins must be pumped by the heart through the lungs and into the body's arteries against the high pressure in the arteries. In order to accomplish this work, the heart's muscle must produce and use energy ("fuel"), and this requires consumption of oxygen that is supplied by the blood. Angina (angina pectoris or "heart pain") is due to an inadequate flow of blood (and oxygen) to the muscle of the heart.
Nitrates, including isosorbide dinitrate, increase the flow of blood and oxygen to the heart and thereby increase the amount of work that the heart can do by dilating (expanding) the arteries and veins in the body. Dilation of the veins reduces the amount of blood that returns to the heart that must be pumped, while dilation of the arteries lowers the pressure in the arteries against which the heart must pump. As a consequence of both effects, the heart works less and requires less blood and oxygen.
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