Isosorbide dinitrate (ISDN) is chemically related to glyceryl trinitrate and also has a similar mechanism of action; it directly produces the relaxation of the arterial smooth muscle at the postcapillary sphincter (dilation of the venous capacitance bed — reduction of the venous return — reduction of preload) and to a lesser extent at the arterial resistance vessels (reduction of afterload). The myocardial oxygen requirements are thus reduced. The epicardial coronary arteries are dilated even in stenotically altered vessel parts.

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