Intermittent transdermal nitroglycerin monotherapy in stable exercise-induced angina: a comparison with a continuous schedule

European Heart Journal
M FerratiniG Pollavini

Abstract

The aim of this study was to investigate nitrate tolerance during continuous treatment with nitroglycerin patches (NTG) as monotherapy, and to assess whether tolerance might be prevented by an overnight nitrate-free interval. Ten male patients, of mean age 53.2 years (range 41-62 years), with pathological coronary angiography and stable exercise-induced angina pectoris took part in a double-blind crossover study (two 15-day periods), during which the continuous and intermittent (12-h nitrate-free interval) application of NTG 20 mg (24 h)-1 patches were compared. Single-blind placebo was given acutely before and at the end of the crossover. Exercise testing was performed on a treadmill according to the Bruce protocol 4 and 12 h after dosing, both during placebo and at the end of the two active treatment periods. In comparison with continuous treatment, the intermittent administration of 20 mg (24 h)-1 NTG patches significantly increased ischaemic threshold and total work time at the 4th and the 12th hour. Night-time withdrawal of NTG transdermal delivery systems determined during the 15-day period a total of 11 night anginal attacks in six out of 10 patients (0.07 attacks per patient per nitrate-free interval).

Citations

Nov 1, 1992·Postgraduate Medical Journal·S R Maxwell, M J Kendall
Mar 1, 1996·Cardiovascular Drugs and Therapy·T O Klemsdal, K Gjesdal
Oct 20, 2004·Hypertension Research : Official Journal of the Japanese Society of Hypertension·Ken KanamasaUNKNOWN Secondary Prevention Group
May 1, 1995·Clinical and Experimental Pharmacology & Physiology·C L ZhangJ D Horowitz
Oct 1, 1990·Australian and New Zealand Journal of Medicine·D W Whalley, K J Hellestrand
Feb 19, 1998·The New England Journal of Medicine·J D Parker, J O Parker
Jan 1, 1992·British Journal of Clinical Pharmacology·G Olsson, J Allgén
Apr 24, 2007·American Journal of Physiology. Heart and Circulatory Physiology·Akiko FukatsuAkihisa Iguchi
Jun 15, 2011·Circulation Journal : Official Journal of the Japanese Circulation Society·Munenori KosugiKyoichi Mizuno
Aug 1, 1992·British Journal of Clinical Pharmacology·J C Cowan
Jun 1, 1994·Cardiovascular Drugs and Therapy·H L Fung, J A Bauer
Mar 3, 2015·Clinical Science·Karen L AndrewsJaye P F Chin-Dusting
Apr 7, 2005·Clinical and Experimental Pharmacology & Physiology·Elizabeth A KellyJohn D Horowitz
Jan 1, 1993·The Journal of International Medical Research·P Löfdahl
Aug 11, 2006·Current Opinion in Cardiology·Ami B Bhatt, Peter H Stone
Sep 9, 1993·The American Journal of Cardiology·H L Fung

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antianginal Drugs: Mechanisms of Action

Antianginal drugs, including nitrates, beta-blockers, and calcium channel blockers, are used in the treatment of angina pectoris. Here is the latest research on their use and their mechanism of action.

Anxiety Disorders

Discover the latest research on anxiety disorders including agoraphobia, panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder here.

Cardiology Journals

Discover the latest cardiology research in this collection of the top cardiology journals.