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[How nitrate tolerance be prevented in the treatment of ischemic heart disease?]

Z Sadowski1, M Kośmicki

  • 1Kliniki Choroby Wieńcowej Instytutu Kardiologii w Warszawie.

Wiadomosci Lekarskie (Warsaw, Poland : 1960)
|March 15, 2001
PubMed

Insights

Organic nitrates treat ischaemic heart disease but tolerance limits their use. Intermittent dosing can prevent this tolerance, maintaining the anti-anginal effects of nitrate therapy.

Area of Science:

  • Pharmacology
  • Cardiovascular Medicine
  • Cell Biology

Context:

  • Organic nitrates are a cornerstone therapy for chronic ischaemic heart disease.
  • Nitrate tolerance significantly diminishes the long-term clinical efficacy of these anti-anginal agents.

Purpose:

  • To review the cellular mechanisms underlying nitrate tolerance.
  • To explore theories explaining tolerance, including oxidative stress and endothelin-1.
  • To discuss clinical strategies for preventing tolerance, such as intermittent dosing.

Summary:

  • This paper investigates the cellular effects of organic nitrates and the mechanisms contributing to tolerance.
  • It examines current theories on nitrate tolerance, focusing on vascular superoxide and endothelin-1.
  • The review highlights intermittent nitrate dosing as a clinical strategy to overcome tolerance.

Impact:

  • Provides insights into the cellular basis of nitrate tolerance.
  • Informs clinical practice regarding optimizing long-term nitrate therapy for ischaemic heart disease.
  • Suggests practical interventions to maintain the therapeutic benefits of nitrates.

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