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Mechanisms of nitrate tolerance: potential roles of folate

F Iachini Bellisarii1, S Gallina, M Zimarino

  • 1Center of Excellence on Aging, University, Chieti, Italy.

European Journal of Clinical Investigation
|November 26, 2003
PubMed

Insights

Nitrates are used for ischaemic heart disease, but tolerance limits their effectiveness. Newer research suggests folic acid may prevent this nitrate tolerance by reducing oxidative stress.

Area of Science:

  • Cardiovascular medicine
  • Pharmacology

Background:

  • Nitrates remain a cornerstone of ischaemic heart disease treatment.
  • The precise mechanisms underlying nitrate action and tolerance are not fully understood.

Purpose of the Study:

  • To review the mechanism of action of nitrates.
  • To explore the phenomenon of nitrate tolerance.
  • To discuss the role of folic acid in mitigating nitrate tolerance.

Main Methods:

  • Literature review of nitrate pharmacology.
  • Analysis of studies investigating nitrate tolerance mechanisms.
  • Examination of research on folic acid's role in cardiovascular therapy.

Main Results:

  • Nitrate tolerance is linked to increased intracellular oxidative stress.
  • Folic acid derivatives show potential in preventing or attenuating nitrate tolerance.
  • Understanding these mechanisms can optimize nitrate therapy.

Conclusions:

  • Nitrate therapy for ischaemic heart disease is established but limited by tolerance.
  • Oxidative stress is a key factor in nitrate tolerance development.
  • Folic acid represents a promising strategy to overcome nitrate tolerance and improve long-term efficacy.

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