What is the role of nitrates in stable angina management?

• A. Relieve chest pain by venodilation reducing preload; used for acute relief
• B. Improve mortality
• C. Increase afterload
• D. Change heart rate

Answer: (A)

Nitrates relieve angina primarily by reducing the amount of blood returning to the heart, which lowers preload. This venodilation decreases left ventricular wall stress and oxygen demand, helping the heart work more efficiently and pain subsides. Because they act to rapidly relieve ischemia, they’re used for acute relief of angina symptoms with nitroglycerin given sublingually or by spray. They don’t aim to improve long-term survival in stable angina, and their main effect is not to alter afterload or directly change heart rate (though blood pressure changes can reflexively influence rate). In short, their role is to quickly relieve chest pain by venodilation and reduced preload.