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Organic nitrates in cardiovascular disease
1Institut für Klinische Pharmakologie, Otto-von-Guericke-Universität, Magdeburg, Germany.
Cellular and Molecular Biology (Noisy-Le-Grand, France)
|September 30, 2005
Summary
Organic nitrates, activating the vascular NO/cGMP pathway, offer unique hemodynamic benefits and potential cardioprotective effects. While generally safe, further trials are needed to clarify their role beyond symptomatic relief in cardiovascular diseases.
Area of Science:
- Cardiovascular Pharmacology
- Vascular Physiology
Background:
- Nitric oxide (NO)/cyclic guanosine monophosphate (cGMP) pathway activation is key in vascular function.
- Organic nitrates generate NO, influencing hemodynamic changes uniquely.
Purpose of the Study:
- To explore the hemodynamic effects of organic nitrates.
- To assess their cardioprotective and vasoprotective potential.
- To investigate nitrate tolerance and associated toxicities.
Main Methods:
- Review of animal experiments and clinical investigations on organic nitrates.
- Analysis of hemodynamic changes, including venodilation and arterial dilation.
- Evaluation of effects on aortic distensibility and Windkessel function.
Main Results:
- Organic nitrates induce preferential venodilation and vessel-size specific arterial dilation.
- Nitrates improve aortic distensibility and Windkessel function.
- Early nitrate therapy in myocardial infarction enhances enalapril's benefits; they improve heart failure survival, but effects in stable angina are unknown.
Conclusions:
- Nitrates are generally safe and well-tolerated, offering symptomatic relief.
- Nitroglycerin-induced tolerance may involve vascular toxicity, unlike other nitrates.
- Further clinical trials are essential to determine the full therapeutic potential of nitrates in cardiovascular disease.