# Is nitrogylcerin still prescribed for those with a history of MI?

**URL:** <https://boards.straightdope.com/t/is-nitrogylcerin-still-prescribed-for-those-with-a-history-of-mi/585467>\
**Category:** Factual Questions\
**Created:** [June 14, 2011, 6:17pm UTC](https://boards.straightdope.com/t/is-nitrogylcerin-still-prescribed-for-those-with-a-history-of-mi/585467 "2011-06-14T18:17:18Z")\
**Posts on this page:** 9\
**Page:** 1

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**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\
**Post date:** [June 14, 2011, 6:17pm UTC](https://boards.straightdope.com/t/is-nitrogylcerin-still-prescribed-for-those-with-a-history-of-mi/585467/1 "2011-06-14T18:17:18Z")

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…or is it \*only \*for stable angina?

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**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\
**Post date:** [June 14, 2011, 6:25pm UTC](https://boards.straightdope.com/t/is-nitrogylcerin-still-prescribed-for-those-with-a-history-of-mi/585467/2 "2011-06-14T18:25:49Z")

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I prescribe it for folks who I feel may have an episode of angina, and would not hesitate to use it in unstable angina either. It’s also helpful as a treatment for certain types of hypertension, and also can be useful in congestive heart failure.

So no, it’s not _only_ for stable angina.

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**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\
**Post date:** [June 14, 2011, 6:33pm UTC](https://boards.straightdope.com/t/is-nitrogylcerin-still-prescribed-for-those-with-a-history-of-mi/585467/3 "2011-06-14T18:33:58Z")

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Thanks, **QtM**. That’s what I thought.

My SO’s new doc won’t renew it, even though every other doc he’s seen for 11 years post MI wanted him to have it, just in case. (He still has significant risk factors for another MI.)

Just wanted the GQ answer - you obviously can’t tell whether my guy should have it, since he’s not your patient - because the doc’s claim that it’s “only” for stable angina these days made me go :dubious:.

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**Author:** ![wonky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wonky/32/393_2.png) [@wonky](https://boards.straightdope.com/u/wonky)\
**Post date:** [June 14, 2011, 6:37pm UTC](https://boards.straightdope.com/t/is-nitrogylcerin-still-prescribed-for-those-with-a-history-of-mi/585467/4 "2011-06-14T18:37:24Z")

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My husband was on nitroglycerin for unstable angina. He had both “emergency” nitro and isosorbide mono that he took daily.

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**Author:** ![Wizard\_One](https://avatars.discourse-cdn.com/v4/letter/w/6a8cbe/32.png) [@Wizard\_One](https://boards.straightdope.com/u/Wizard_One)\
**Post date:** [June 15, 2011, 6:52am UTC](https://boards.straightdope.com/t/is-nitrogylcerin-still-prescribed-for-those-with-a-history-of-mi/585467/5 "2011-06-15T06:52:41Z")

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My father is 81. Until I redeployed home, he did the revolving door number at the local hospital with congestive heart failure.  
After quite a lot of attention to his care regimen, to include abandoning our own home and moving in with him, he’s finally stable, if lately fall prone.  
At HOME, he’s not on nitro, but WAS for many years. First treatment at hospital is ALWAYS nitro. It remains for the duration of his stay.  
So, it seems to be relative, depending on the healthcare professional. Guidelines are one thing, actual practice another. 😕

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**Author:** ![aruvqan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/aruvqan/32/2891_2.png) [@aruvqan](https://boards.straightdope.com/u/aruvqan)\
**Post date:** [June 15, 2011, 10:16am UTC](https://boards.straightdope.com/t/is-nitrogylcerin-still-prescribed-for-those-with-a-history-of-mi/585467/6 "2011-06-15T10:16:17Z")

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> [@Qadgop\_the\_Mercotan](#):
>
> I prescribe it for folks who I feel may have an episode of angina, and would not hesitate to use it in unstable angina either. It’s also helpful as a treatment for certain types of hypertension, and also can be useful in congestive heart failure.
> 
> So no, it’s not _only_ for stable angina.

Really? I never heard of it being used for hypertension, just angina. What kinds of hypertension? And I also didn’t know there were 2 kinds of nitro =)

The benefits of being on a message board of people who like facts for the fun of knowing them 😃

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**Author:** ![VunderBob](https://avatars.discourse-cdn.com/v4/letter/v/839c29/32.png) [@VunderBob](https://boards.straightdope.com/u/VunderBob)\
**Post date:** [June 15, 2011, 10:34am UTC](https://boards.straightdope.com/t/is-nitrogylcerin-still-prescribed-for-those-with-a-history-of-mi/585467/7 "2011-06-15T10:34:47Z")

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> [@aruvqan](#):
>
> Really? I never heard of it being used for hypertension, just angina. What kinds of hypertension? And I also didn’t know there were 2 kinds of nitro =)

Sky-high hypertension, systolic (upper number) greater than 200, diastolic exceeding 150.

BP that high puts the patient at risk for an immediate bleeding stroke. Nitro is a vasodilator, allowing the venous system to relax and thereby increasing blood vessel diameter, decreasing resistance to flow.

It’s a short term treatment to get the blood pressure down immediately before we got the patient to the hospital. The ER doc would then make diagnoses and give prescriptions for long term treatment.

The vasodilation is also why nitro users and dynamite handlers get those killer headaches. The relaxed vessels allow the blood to flow better, and causes direct impingement on brain tissue

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**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\
**Post date:** [June 16, 2011, 12:32am UTC](https://boards.straightdope.com/t/is-nitrogylcerin-still-prescribed-for-those-with-a-history-of-mi/585467/8 "2011-06-16T00:32:01Z")

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> [@aruvqan](#):
>
> Really? I never heard of it being used for hypertension, just angina. What kinds of hypertension? And I also didn’t know there were 2 kinds of nitro =)

It can be useful in refractory essential hypertension. It’s not one of my first go-to meds to get the BP under control, or even my 3rd or 4th, but a nice long-acting mono or bi-nitrate compound can be a very effective maintenance drug, especially in folks with a history of coronary artery disease. Nitro patches can work nicely that way too.

And there’s more than two kinds of nitro, for sure…

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**Author:** ![VunderBob](https://avatars.discourse-cdn.com/v4/letter/v/839c29/32.png) [@VunderBob](https://boards.straightdope.com/u/VunderBob)\
**Post date:** [June 16, 2011, 12:41am UTC](https://boards.straightdope.com/t/is-nitrogylcerin-still-prescribed-for-those-with-a-history-of-mi/585467/9 "2011-06-16T00:41:51Z")

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> [@Qadgop\_the\_Mercotan](#):
>
> And there’s more than two kinds of nitro, for sure…

I’ve never administered the paste, but my old squad carried it. I’m in the process of joining the new one, and I have no clue what they carry at the moment.
