What should be monitored in a patient receiving long-term nitrate therapy for angina?

In patients receiving long-term nitrate therapy for angina, monitoring for the development of tolerance is crucial. Nitrate tolerance can occur when the body becomes accustomed to the effects of nitrates, leading to reduced efficacy in controlling angina symptoms over time. This is particularly significant because it can result in worsening angina or the need for higher doses, which may not be safe or effective.

The development of tolerance often necessitates careful management strategies, such as incorporating nitrate-free intervals to restore sensitivity. Understanding this aspect is essential for optimizing treatment, ensuring that patients receive the maximum benefit from their therapy while minimizing risks.

While other factors like signs of myocardial infarction, potential drug interactions, and kidney function are important in managing angina and overall patient health, monitoring for tolerance specifically addresses an inherent complication of long-term nitrate use, making it a primary focus in this context.