Key result
Nitroglycerin promptly relieves angina by increasing blood flow and reducing oxygen demand in ischemic myocardium, but sudden withdrawal may precipitate coronary vasoconstriction.
Nitroglycerin effectively relieves angina by improving myocardial oxygen supply and demand, though sudden withdrawal carries risks of rebound vasoconstriction.
May warrant gradual nitroglycerin withdrawal to avoid rebound vasoconstriction in angina; leaves open optimal protocols for prospective trials.
How nitroglycerin relieves angina pectoris is only now becoming clear. It increases blood flow to and reduces the oxygen needs of ischemic myocardium, relieving pain promptly in most cases. Sudden withdrawal of the drug may precipitate significant symptoms from coronary vasoconstriction.
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Aagaard et al. (1973) studied this question. Nitroglycerin promptly relieves angina by increasing blood flow and reducing oxygen demand in ischemic myocardium, but sudden withdrawal may precipitate coronary vasoconstriction.
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