What can happen as a result of excessive use of nitrates?

Excessive use of nitrates can lead to the development of tolerance. Nitrates are commonly used as antianginal agents to help relieve angina by dilating blood vessels, which reduces the heart’s workload and increases blood flow to the heart muscle. However, with prolonged exposure to nitrates, the body can adapt, resulting in a decreased response to the drug over time. This phenomenon occurs because the mechanisms by which nitrates exert their effects can become less effective due to continued stimulation.

When tolerance develops, patients may find that they require higher doses of nitrates to achieve the same therapeutic effect, or even that the medication becomes less effective at relieving angina. This can complicate treatment and necessitate changes in the management approach to ensure that the heart continues to receive adequate oxygen supply during episodes of ischemia. Consequently, it is important for healthcare providers to monitor patients closely and consider nitrate-free intervals to mitigate the risk of tolerance.