Harvard Heart Letter

Ask the doctor: Should I take nitroglycerin during exercise?

Ask the doctor

Should I take nitroglycerin during exercise?

Q. I have had a prescription for nitroglycerin (Nitrostat) for a number of years, but I rarely need to use it. Every once in a while, though, when I am on the treadmill, I feel my chest start to tighten up. I stop, take a pill, then continue exercising without any chest pain. The result is a great workout; the only drawback is a short-term mild headache. Some years ago, I read a column by a doctor who said it would be "ludicrous" to take nitroglycerin in order to continue exercising. What do you think?

A. My colleagues and I routinely advise our patients who develop chest pain on exertion (angina) to take nitroglycerin before they exercise in order to prevent an attack. Taking a pill in the middle of an exercise session is a little different. I tell my patients that if they have an angina attack while exercising to stop and take it easy for a few hours rather than getting right back on the treadmill.

If you find that exercise is provoking angina more regularly, or at lower exertion, it is possible that one or more of your coronary arteries is narrowing further. Talk with your doctor about beefing up what you are doing to counter angina and protect your heart and arteries, or perhaps having some tests to see if more needs to be done.

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