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Nitrates III - Cardiovascular Effects (Paperback, Softcover reprint of the original 1st ed. 1981)
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Nitrates III - Cardiovascular Effects (Paperback, Softcover reprint of the original 1st ed. 1981)
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Pharmacological and clinical research on nitrates continues to be
of growing interest in many centers. This is surprising in view of
the fact that their favorable effects in angina pectoris were
described by Brunton and by Murrell in the Lancet more than 100
years ago. As expected, a host of new information has been
collected since the two previous symposia on nitrates held in
Stockholm in 1975 and Berlin in 1978. New insights were gained into
the pharmacology, pharmacokinetics and pharmacodynamics of
nitrates, as well as into their clinical effects in acute and
chronic ischemic heart diseases and in severe congestive heart
failure. Relatively little progress, however, was observed in
research into the basic action of nitrates. Although most
investigators agree that intracellular sequestration of calcium is
probably the main mechanism by which nitrates lead to the reduction
of vascular smooth muscle tone, the exact site of their action
still remains undefined. In contrast, dose-dependent differences in
venous and arteriolar tone have long been clearly established.
Treatment was again in the main stream of discussion. The question
of tolerance following long-term administration was discussed in
depth and the term "pseudotolerance" was introduced to describe the
adaptation of the body's circulatory system to chronic
vasodilation. This is especially important in long term
prophylactic antiischemic treatment in stable, as well as in
unstable angina pectoris (i.e. during increased vasomotor tone -
spasm).
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