Isosorbide Dinitrate and Heart Failure - - Using the Nitrate Isosorbide Dinitrate to Treat Heart Failure

(LifeWire) - In the considerable arsenal of drugs available to treat heart failure, the nitrate isosorbide dinitrate is a perennial pick of doctors because of its ability to relieve some of patients' most troubling symptoms.

By causing the arteries and veins around the heart to widen, isosorbide dinitrate lessens the heart's workload -- an important consideration in heart failure, which affects about 5 million Americans and contributes to 300,000 deaths yearly. Heart failure doesn't mean the heart simply stops. Rather, the organ cannot pump as efficiently as normal and circulate oxygen-rich blood throughout the body.

Heart failure has many possible causes, including prior heart attack, high blood pressure, diabetes or any other cardiac condition that damages the heart's ability to function. The effects include chronic weakness, fluid retention, coughing, lung congestion and shortness of breath.

Roughly one-third of all heart failure patients are African Americans. Researchers have found that isosorbide dinitrate, when combined with another medication called hydralazine, boosts survival rates for this group. The addition of hydralazine enhances the effectiveness of the nitrate because African Americans don't respond as well to nitrates as other groups do.

Doctors decide which heart failure drugs to give their patients based on individual symptoms and contributing factors such as drug side effects. Patients often build up a tolerance to isosorbide dinitrate (and to other nitrates) that may requires taking short breaks from it. Those who take erectile dysfunction medications such as Viagra should avoid isosorbide dinitrate -- and all nitrates in general -- because the combination can dangerously lower blood pressure (hypotension) and even cause death.

Hypotension is one of the more common side effects of nitrates in general. Others include dizziness, fainting, heart palpitations, headaches, nausea and facial flushing.

Since isosorbide dinitrate -- which is available by several brand names, including Isordil, Dilatrate and Isochron -- can increase pressure in the skull and behind the eyes. Those who have conditions such as glaucoma and head trauma should not take it.

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