Here in USA it is sublingual oral tablets for most people.

Severe cases get the patches. We also have an ointment, but that requires measuring, so it may be used more often in nursing homes.

In USA there has been a recall of all Ethex products and they had about 80-90% of the market. So the brand name is being used more (by Pfizer---called Nitrostat).

We also have long acting nitro type oral drugs. Nitroglycerin sustained capsules and synthetic types called Imdur (isosorbide mononitrate). These latter are used more than the older nitro caps. Imdur is also used to just improve vasodilation for cerebral vessels or other uses like blood pressure treatment (usually an add-on type drug).

Because USA is aggressive with bypass surgeries and stents, nitro products are not huge sellers here. Hence the spray would even be less common. People who cannot have surgery-- are risks-- or have no insurance would get the drugs, as opposed to insured patients who would get the stents/bypass.

I think there are cultural differences.