Current perspectives. Therapy with organic nitrates: newer ideas, more controversies.

Abstract

Because of their potent hemodynamic effects, organic nitrates have been introduced in the cardiovascular pharmacopoeia since more than a century in the treatment of coronary artery disease and congestive heart failure. Today, nitroglycerin is the most commonly prescribed generic drug in Italy. While their hemodynamic effects and some of their side effects (e.g. nitrate tolerance, the rebound phenomenon) are at least in part known, little is known regarding other effects of nitrates, for instance their antiaggregant, preconditioning-mimetic, and antiatherosclerotic properties. These effects might have tremendous importance in the treatment of cardiovascular patients. At the same time, the effects of nitrate-derived oxygen free radical species require further investigation. This review provides an update on recent findings in this field.