Therapeutic efficacy of a new transdermal system containing nitroglycerin in patients with angina pectoris

The results of a placebo-controlled, double-blind cross-over study in 13 patients with angina pectoris demonstrated that daily application of a newly developed, transdermal therapeutic system for the administration of nitroglycerin (NTG-TTS) over a period of 14 days reduced the daily frequency of anginal attacks by 67%, and the daily consumption of nitrates by 63%. Systolic and diastolic blood pressures were significantly lowered by 10 mmHg and 7.5 mmHg, respectively. The exercise-induced increase in blood pressure was not influenced by NTG-TTS, but it occurred at a lower level. Heart rate was not increased by NTG-TTS, either at rest or upon exercise. Exercise-induced depression of the ST segment diminished by about 50%, and anginal attacks were distinctly less severe and of shorter duration NTG application. Development of tolerance was not detected; on the contrary, the anti-anginal effect was more pronounced in the second than in the first week of medication. NTG had no effect on haematological parameters or blood chemistry, and methaemoglobin formation was not observed. Cutaneous tolerability of the system was good and its application posed no major problem.