Diabetologia (1994) 37:115-117 Diabetologia 9 Springer-Verlag 1994 For debate G . M c V e i g h 1, G . B r e n n a n 2, R . H a y e s 3, D . J o h n s t o n 2 1 Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA 2 Department of Therapeutics and Pharmacology, Belfast City Hospital, Belfast, Northern Ireland 3 Department of Medicine, Belfast City Hospital, Belfast, Northern Ireland First synthesised in 1846, glyceryl trinitrate was employed clinically as early as 1879 to treat angina pectoris. Today organic nitrates remain a cornerstone in the treatment of chronic stable and unstable angina, acute myocardial infarction, and acute and chronic congestive cardiac failure. The drugs act to produce smooth muscle relaxation that results in dilation of veins, arteries and arterioles. Venodilation that results in pooling of blood in the capacitance vessels occurs at very low plasma concentrations, while arteriolar dilation resulting in a fall in blood pressure and systemic resistance require larger doses of nitrates. The reduction in cardiac preload and afterload decreases myocardial oxygen demand and serves as the main mechanism by which nitrates relieve angina and myocardial
Diabetologia – Springer Journals
Published: Jan 1, 1994
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