This review of studies on anti-anginal agents and their use in the anginal syndrome shows nitroglycerin to be unsurpassed in clinical effectiveness. It has a rapid onset of action. Its duration of action is relatively short but the need for a more prolonged effect has not been demonstrated. Most anginal attacks subside upon resting and the requirement for relief is immediate rather than prolonged. A long-acting anti-anginal agent would have some value if it could prevent precipitation of an anginal episode but there is no convincing evidence to indicate that these drugs have this capability. In general, clinical experience with long-acting nitrites is relatively unsatisfactory.
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