Coronary Artery Disease (CAD) and Angina and Vasodilators

People with coronary artery disease (CAD) have blood vessels that are narrowed, which reduces the amount of blood that can be delivered to the heart muscle. Vasodilators help enlarge (dilate) blood vessels. Nitrates or nitroglycerin may be used to immediately relieve an attack of angina that is occurring, or prevent or reduce future attacks.

Common vasodilators include nitroglycerin (e.g. Minitran and Nitro-Bid).

Over time, the body may develop a tolerance to nitroglycerin. According to a small, double-blind, placebo-controlled crossover study, use of arginine (700 mg four times daily) may help prevent tolerance to nitrate medications.⁴⁴

Vasodilators help enlarge (dilate) blood vessels, enhancing blood flow through otherwise narrowed vessels. Ultimately, the heart can work better, because more blood is delivered to its muscle tissues.

Read more details about Vasodilators.

Nitrates come in many preparations, including tablets, sprays (for use under the tongue), ointments, or patches for placement on the skin. The tablets or sprays are used at times of anginal episodes, while the ointment or patch is used on a daily basis for prevention of attacks.

Possible side effects of vasodilators include:

• Sudden drop in blood pressure
• Dizziness or lightheadedness, especially when getting up from a lying or sitting position
• Fast pulse, racing heart or palpitations (tachycardia)
• Flushing of face and neck
• Headache
• Nausea or vomiting
• Restlessness
• Fluid retention

44. Parker JO, Parker JD, Caldwell RW, et al. The effect of supplemental L-arginine on tolerance development during continuous transdermal nitroglycerin therapy. J Am Coll Cardiol. 2002;39:1199-1203.