What is the role of nitrates in the treatment of angina?

The role of nitrates in the treatment of angina primarily involves their ability to reduce chest pain by dilating blood vessels. Nitrates work by relaxing the smooth muscle in the walls of blood vessels, leading to vasodilation. This vasodilation decreases the preload and myocardial oxygen demand by reducing the amount of blood returning to the heart. Additionally, nitrates can also relieve coronary artery vasospasm, further improving blood flow to the myocardium.

By increasing blood flow and oxygen supply to the heart muscle while simultaneously decreasing the heart's workload, nitrates effectively alleviate the ischemic pain associated with angina. Therefore, their primary role is to enhance myocardial perfusion and mitigate chest discomfort, making them an essential component in the management of angina symptoms.