EFFECT OF 2 WEEKS THERAPY WITH ISOSORBIDE -5-MONONITRATE ON EXERCISE TOLERANCE AND FREQUENCY OF ANGINAL ATTACKS IN PATIENTS WITH STABLE ANGINA

Effect of isosorbide-5-mononitrate (40 mg/day for 2 weeks) on toleranc e to exercise was investigated in 22 patients with ischemic heart dise ase and stable effort angina in a placebo-controlled cross-over study, Compared to placebo isosorbide-5-mononitrate substantially prolonged time to ischemic ECG changes, increased double product and total work, and decreased number of consumed nitroglycerin tablets (a reflection of quality of life of patients with angina) by 44%, Other effects char acteristic of nitrates as a class such as tachycardia and blood pressu re lowering were also noted. Some attenuation of antiischemic effect o f isosorbide-5-mononitrate occurred after 2 weeks of treatment in 65% of patients however this effect remained to be significant. Complete t olerance to antiischemic action of isosorbide-5-mononitrate developed in 2 patients (12%) while there were no cases of tolerance to hypotens ive and heart rate accelerating actions.