Nitrates and other nitric oxide donors in cardiology: current positioning and perspectives

Area of Science:

• Cardiovascular Medicine
• Pharmacology

Background:

• Nitric oxide (NO) donors have a long history in treating cardiovascular diseases.
• Despite widespread use, cardiologists lack consistent guidelines on their indications and administration.
• Contradictory pharmacodynamics, including acute efficacy versus long-term tolerance and endothelial dysfunction, create therapeutic challenges.

Purpose of the Study:

• To review recent biochemical and pathophysiological findings on nitric oxide donors.
• To re-evaluate the role of nitrates and other NO donors in cardiovascular medicine.
• To compare international guidelines and identify areas needing further clinical research.

Main Methods:

• Literature review of biochemical and pathophysiological studies.
• Analysis of pharmacodynamic properties of NO donors.
• Comparative review of international clinical guidelines.

Main Results:

• Acute administration of NO donors is effective.
• Long-term use may be limited by tolerance and endothelial dysfunction.
• Inconsistent clinical application highlights a need for clearer guidance.

Conclusions:

• The long-term efficacy and safety of nitric oxide donors require further investigation.
• Clarifying indications and optimal administration is crucial for consistent clinical practice.
• More clinical research is warranted to address current uncertainties regarding NO donor therapy.