Nitrate-induced toxicity and preconditioning: a rationale for reconsidering the use of these drugs

Although organic nitrates have been clinically used for more than a century, findings in the last decade have radically challenged our traditional view concerning the mechanism(s) of their clinical effects and implications. While their hemodynamic properties are well known, the knowledge that nitrates possess previously unexpected nonhemodynamic effects is a unique opportunity of which clinicians should be aware but, at the same time, it also provides a rationale to worry about previously unanticipated clinical consequences of long-term treatment with these drugs.