Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Nitrate tolerance--problems both new and old

J O Parker1

  • 1Department of Medicine, Queen's University, Kingston, Ontario.

The Canadian Journal of Cardiology
|May 1, 1996
PubMed
Summary
This summary is machine-generated.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

ARCTIC: assessment of haemodynamic response in patients with congestive heart failure to telmisartan: a multicentre dose-ranging study in Canada.

American heart journal·1999
Same author

Congenital arteriovenous fistula of internal thoracic artery: successfully managed by transcatheter embolization.

Catheterization and cardiovascular diagnosis·1998
Same author

Nitrate therapy for stable angina pectoris.

The New England journal of medicine·1998
Same author

Cardiovascular death and left ventricular remodeling two years after myocardial infarction: baseline predictors and impact of long-term use of captopril: information from the Survival and Ventricular Enlargement (SAVE) trial.

Circulation·1997
Same author

The effect of hydralazine on the development of tolerance to continuous nitroglycerin.

The Journal of pharmacology and experimental therapeutics·1997
Same author

Effects of diuretic therapy on the development of tolerance to nitroglycerin and exercise capacity in patients with chronic stable angina.

Circulation·1996
Same journal

Percutaneous Coronary Intervention Prior to Transcatheter Aortic Valve Implantation: A Bayesian Meta-Analysis of Randomized Controlled Trials.

The Canadian journal of cardiology·2026
Same journal

Practical approach to the assessment of technical scanning skills in transthoracic echocardiography.

The Canadian journal of cardiology·2026
Same journal

Cost-effectiveness of Pharmacist- and Nurse Practitioner-led Medication Management for Heart Failure With Reduced Ejection Fraction.

The Canadian journal of cardiology·2026
Same journal

Rethinking Pacing After Transcatheter Aortic Valve Implantation to Preserve Ventricular Function.

The Canadian journal of cardiology·2026
Same journal

High Intensity Interval Training Versus Moderate Continuous Training in Adults with Congenital Heart Disease: A Randomized Controlled Trial.

The Canadian journal of cardiology·2026
Same journal

Four-Chamber Myocardial Strain to Predict Mortality in Pulmonary Embolism.

The Canadian journal of cardiology·2026
See all related articles

Nitrate tolerance rapidly reduces medication effectiveness, impacting treatment. Intermittent dosing preserves therapeutic nitrate effects by allowing washout periods.

Area of Science:

  • Pharmacology
  • Cardiovascular Medicine

Background:

  • Nitrate tolerance is a significant clinical issue, rapidly attenuating therapeutic effects during continuous administration.
  • Understanding the mechanisms of nitrate tolerance is crucial for effective cardiovascular treatment strategies.

Purpose of the Study:

  • To review the current understanding of nitrate tolerance, its mechanisms, and strategies for management.
  • To highlight the clinical significance of nitrate tolerance in daily therapeutic use.

Main Methods:

  • Literature review of studies on nitrate tolerance.
  • Analysis of proposed mechanisms including sulfhydryl depletion, neurohormonal activation, and oxidative stress.
  • Evaluation of clinical strategies to prevent or reverse tolerance.

Related Experiment Videos

Main Results:

  • Rapid tolerance develops with oral, transdermal, and intravenous nitrate administration.
  • Proposed mechanisms include sulfhydryl group reduction, neurohormonal activation, plasma volume expansion, and superoxide production.
  • Attempts to prevent tolerance with sulfhydryl donors or other agents have shown limited success.

Conclusions:

  • Nitrate tolerance significantly limits the efficacy of continuous nitrate therapy.
  • Intermittent nitrate dosing, providing washout periods, is an effective strategy to preserve therapeutic benefits.