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Related Experiment Videos

Update on nitrate tolerance.

J O Parker1

  • 1Cardiovascular Laboratory, Kingston General Hospital, Ontario, Canada.

British Journal of Clinical Pharmacology
|January 1, 1992
PubMed
Summary

Continuous nitrate therapy can lead to tolerance, reducing its effectiveness. This occurs due to depleted sulphydryl groups and activated counter-regulatory systems, impacting haemodynamic and clinical outcomes.

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Area of Science:

  • Cardiovascular Pharmacology
  • Pharmacology

Background:

  • Continuous 24-hour nitrate therapy is known to induce tolerance.
  • Nitrate tolerance diminishes both haemodynamic and clinical effects.

Purpose of the Study:

  • To elucidate the mechanisms underlying nitrate tolerance.
  • To understand how counter-regulatory systems modulate nitrate effects.

Main Methods:

  • Review of existing literature on nitrate tolerance mechanisms.
  • Analysis of factors contributing to diminished vasodilatation.

Main Results:

  • Nitrate tolerance is linked to reduced vascular smooth muscle sulphydryl groups.
  • Activation of counter-regulatory systems like catecholamines, vasopressin, and the renin-angiotensin system contributes to tolerance.
  • Renin-angiotensin system activity causes sodium and water retention, expanding plasma volume.

Conclusions:

  • Nitrate tolerance mechanisms involve biochemical and physiological counter-regulatory responses.
  • Increased vasoconstrictor influences and plasma volume expansion can offset nitrate-induced vasodilation.

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