| Effects of diuretic therapy on the development of tolerance to nitroglycerin and exercise capacity in patients with chronic stable angina. | |
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MedLine Citation:
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PMID: 8640997 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Therapy with diuretics has been reported to prevent the development of nitrate tolerance. Importantly, diuretics may have independent antianginal effects through their effects on intravascular volume. The present investigation was designed to determine whether diuretic therapy could prevent the development of tolerance to continuous transdermal nitroglycerin. The study was also designed to examine whether diuretic therapy has an independent antianginal effect. METHODS AND RESULTS: Twelve patients with chronic stable angina were studied in a randomized, double-blind, crossover trial. Patients received diuretic (hydrochlorothiazide plus amiloride) or placebo for 14 to 20 days. During each double-blind treatment period, patients underwent treadmill exercise testing on three separate occasions. The first exercise testing was performed after 7 to 10 days of single-blind, placebo transdermal nitroglycerin therapy. Subsequently, exercise testing was repeated on the first day of active transdermal nitroglycerin therapy and following 7 to 10 days of continuous transdermal nitroglycerin application. Therapy with a diuretic was associated with an increase in exercise capacity but had no effect on nitroglycerin tolerance. During therapy with placebo transdermal nitroglycerin, diuretic therapy caused an increase in treadmill walking time to the development of moderate angina compared with placebo (371 +/- 26 versus 288 +/- 16 seconds, diuretic versus placebo, P < .01). Similar results were obtained during both acute and sustained nitroglycerin therapy. CONCLUSIONS: The results of this study demonstrate that therapy with a diuretic has no effect on the development of tolerance to continuous transdermal nitroglycerin. Interestingly, diuretic therapy itself has important antianginal effects and improves exercise capacity in patients with stable angina. |
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Authors:
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J D Parker; A B Parker; B Farrell; J O Parker |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Circulation Volume: 93 ISSN: 0009-7322 ISO Abbreviation: Circulation Publication Date: 1996 Feb |
Date Detail:
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Created Date: 1996-07-15 Completed Date: 1996-07-15 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 691-6 Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine, Queen's University, Kingston (Ontario) General Hospital, Canada. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Cutaneous Amiloride / administration & dosage, therapeutic use* Angina Pectoris / drug therapy*, physiopathology Blood Pressure / drug effects Chronic Disease Cross-Over Studies Double-Blind Method Drug Therapy, Combination Drug Tolerance Exercise Test Heart Rate / drug effects Humans Hydrochlorothiazide / administration & dosage, therapeutic use* Male Middle Aged Nitroglycerin / administration & dosage, therapeutic use* |
| Chemical | |
Reg. No./Substance:
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2609-46-3/Amiloride; 55-63-0/Nitroglycerin; 58-93-5/Hydrochlorothiazide |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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