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Related Experiment Videos

Nitrates and angina pectoris

J O Parker1

  • 1Kingston General Hospital, Ontario, Canada.

The American Journal of Cardiology
|September 9, 1993
PubMed
Summary
This summary is machine-generated.

Organic nitrates like nitroglycerin work by releasing nitric oxide (NO), a potent vasodilator. However, continuous nitrate therapy leads to tolerance, diminishing their effectiveness for stable angina pectoris.

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Area of Science:

  • Cardiovascular Pharmacology
  • Endocrinology

Background:

  • Organic nitrates are essential in managing stable angina pectoris.
  • Their mechanism involves nitric oxide (NO) release, leading to vasodilation.

Purpose of the Study:

  • To review the mechanisms of action of organic nitrates.
  • To discuss nitrate tolerance and its impact on angina treatment.
  • To explore the broader effects of nitrates beyond vasodilation.

Main Methods:

  • Literature review of organic nitrates' pharmacology.
  • Analysis of mechanisms underlying nitrate tolerance.
  • Evaluation of clinical implications for stable angina patients.

Main Results:

  • Nitrates are prodrugs activated to nitric oxide (NO), which causes vasodilation by increasing cyclic guanosine monophosphate (cGMP).

Related Experiment Videos

  • NO shares properties with endothelium-derived relaxing factor (EDRF), suggesting potential anti-atherosclerotic effects.
  • Sustained nitrate use leads to tolerance, possibly due to sulfhydryl depletion and neurohormonal activation, which is not consistently prevented by other medications.

    • Conclusions:

    • Intermittent nitrate therapy is currently the only effective method to prevent tolerance.
    • Continuous nitrate monotherapy is often unsuitable for stable angina due to tolerance and lack of sustained benefit.