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Neurohormonal activation during nitrate therapy: A possible mechanism for tolerance

Parker, John O ; Parker, John D

The American Journal of Cardiology, 1992, Vol.70(8), pp.B93-B97 [Periódico revisado por pares]

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  • Título:
    Neurohormonal activation during nitrate therapy: A possible mechanism for tolerance
  • Autor: Parker, John O ; Parker, John D
  • Assuntos: Medicine
  • É parte de: The American Journal of Cardiology, 1992, Vol.70(8), pp.B93-B97
  • Descrição: The hemodynamic and antianginal effects of the organic nitrates are greatly reduced during therapy designed to provide 24-hour protection throughout each day. Although the mechanisms of tolerance are nat clearly understood, it is likely that tolerance is related to a combination of reduced sulfhydryl groups in vascular smooth muscle and neurohormoeal activation. These changes would reduce nitrate-induced vasedilation and induce sodium and water reteatlen with an increase in plasma volume. These reflex neurohormonal changes would reduce tho hemodyeamic effect of any given degree of nitrate-induced vasedilation. Although preliminary studies suggest that diuretic therapy or tho use of converting enzyme inhibitors may reduce or abolish tolerance, further clinical studies are required to confirm these findings.
  • Idioma: Inglês

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