What can excessive use of nitrates lead to?

Excessive use of nitrates can lead to the development of tolerance. Nitrates are vasodilators that help improve blood flow to the heart and reduce the workload on the heart muscle. However, with continuous exposure to nitrates, the body can adapt, and their effectiveness diminishes over time. This tolerance occurs because the body becomes accustomed to the constant presence of the medication, leading to a reduced response even at previously effective doses.

When tolerance develops, patients may find that their angina symptoms recur or worsen as the beneficial effects of the nitrates diminish, necessitating higher doses or more frequent dosing to achieve the desired therapeutic effect. This situation can lead to a cycle of increasing dosages without achieving adequate symptom control, highlighting the importance of nitrate-free periods to help minimize the development of tolerance.