[Effect of compound salvia injection on nitrate ester tolerance]

Area of Science:

• Cardiovascular Pharmacology
• Integrative Medicine
• Vascular Biology

Background:

• Nitrate ester tolerance is a common issue in treating coronary heart disease (CHD).
• Understanding the mechanisms behind nitrate tolerance is crucial for effective treatment strategies.
• Compound Salvia injection (CSI) is a traditional medicine with potential cardiovascular benefits.

Purpose of the Study:

• To investigate the efficacy of Compound Salvia injection (CSI) in preventing nitrate ester tolerance.
• To elucidate the underlying mechanisms of CSI's effect on nitrate tolerance.
• To compare the effects of CSI with vitamin C in managing nitrate tolerance.

Main Methods:

• A randomized controlled trial involving 84 CHD patients was conducted.
• Patients were divided into three groups: isosorbide dinitrate (ISD) alone, ISD + CSI, and ISD + vitamin C.
• Vascular function (endothelial-dependent and independent vasodilation), blood pressure, and molecular markers (eNOS, ET-1 mRNA) were assessed.

Main Results:

• CSI significantly reduced the occurrence rate of nitrate tolerance compared to ISD alone.
• CSI improved endothelial-dependent vasodilation and normalized blood pressure more effectively than vitamin C.
• CSI modulated endothelin-1 (ET-1) and endothelial nitric oxide synthase (eNOS) mRNA expression.

Conclusions:

• Compound Salvia injection (CSI) demonstrates a preventative effect against nitrate ester tolerance.
• CSI offers superior benefits over vitamin C in improving vascular endothelial function and preventing tolerance.
• The mechanism involves regulating eNOS and ET-1 mRNA expression, thereby protecting vascular endothelial function.