PMID: 9426022Jan 13, 1998Paper

Long-term nitroglycerin treatment is associated with supersensitivity to vasoconstrictors in men with stable coronary artery disease: prevention by concomitant treatment with captopril

Journal of the American College of Cardiology
Thomas HeitzerT Münzel

Abstract

We examined whether long-term nitroglycerin (NTG) treatment leads to an increase in sensitivity to vasoconstrictors. To assess a potential role of the renin-angiotensin system in mediating this phenomenon, we treated patients concomitantly with the angiotensin-converting enzyme (ACE) inhibitor captopril. The anti-ischemic efficacy of organic nitrates is rapidly blunted by the development of nitrate tolerance. The underlying mechanisms are most likely multifactorial and may involve increased vasoconstrictor responsiveness. Forearm blood flow and vascular resistance were determined by using strain gauge plethysmography. The short-term responses to intraarterial angiotensin II (1, 3, 9 and 27 ng/min) and phenylephrine (an alpha-adrenergic agonist drug, 0.03, 0.1, 0.3 and 1 microg/min) were studied in 40 male patients with stable coronary artery disease. These patients were randomized into four groups receiving 48 h of treatment with NTG (0.5 microg/kg body weight per min) or placebo with or without the ACE inhibitor captopril (25 mg three times daily). In patients treated with NTG alone, the maximal reductions in forearm blood flow in response to angiotensin II and phenylephrine were markedly greater (-64 +/- 3% and -53 +/- 4%, re...Continue Reading

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Citations

Mar 19, 2008·Cardiovascular Drugs and Therapy·John F Beltrame
Aug 10, 2000·Journal of the American College of Cardiology·T MünzelT Meinertz
Dec 29, 2000·Journal of the American College of Cardiology·D Hébert, J Y Lam
Jun 13, 2001·Journal of the American College of Cardiology·Y Y ChirkovJ D Horowitz
Oct 5, 2001·Journal of the American College of Cardiology·T Münzel
Oct 5, 2001·Journal of the American College of Cardiology·T GoriJ D Parker
Dec 19, 1998·Journal of the American College of Cardiology·P R CaramoriJ D Parker
May 17, 2003·Drugs & Aging·Kourosh MoazemiAbraham G Kocheril
Jan 23, 2016·Current Heart Failure Reports·Julio A Chirinos, Payman Zamani
Nov 26, 2003·European Journal of Clinical Investigation·F Iachini BellisariiR De Caterina
Jul 19, 2008·Journal of the American College of Cardiology·Tommaso Gori, John D Parker
Dec 4, 2003·Journal of the American College of Cardiology·John D Parker
Mar 5, 2016·Journal of Cardiovascular Pharmacology and Therapeutics·Sofia Moreira-SilvaJoana Pimenta
May 18, 2011·Circulation·Thomas MünzelTommaso Gori
Jun 21, 2005·Journal of Cardiovascular Pharmacology·Michihito SekiyaKouki Watanabe
Jun 27, 2018·Turkish Journal of Emergency Medicine·Yi-Ting HsiehChee-Fah Chong
Dec 12, 2012·Journal of Cardiovascular Pharmacology and Therapeutics·Sean Jedrzkiewicz, John D Parker
Jan 31, 2009·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·Tommaso Gori, Andreas Daiber
Feb 27, 2016·The Annals of Pharmacotherapy·Erin R WeedaC Michael White

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