For over 100 years nitrates have been used as vasodilators. It is now almost 50 years since Meyer1 showed that nitroglycerin caused dilatation of the coronary arteries of a dog. Subsequently, many nitrates have been used in a search for one with a longer duration of action than nitroglycerin. Of the nitrate compounds with prolonged action, pentaerythritol (Peritrate) tetranitrate, or PETN, has received the greatest clinical acceptance.
While coronary dilatation with nitrates has been objectively demonstrated in animals, a similar effect in human beings is less well documented, especially in those clinical situations in which these drugs have proved most useful. The failure to confirm the effectiveness of nitrates in the abnormal circulation of patients with arteriosclerotic heart disease results from the technical difficulty encountered in determining coronary blood flow in intact human beings.
Evidence that these drugs have a beneficial effect on coronary circulation in patients with arteriosclerotic
Johnson PC, Sevelius G. MEASUREMENT OF MYOCARDIAL BLOOD FLOWRADIOISOTOPE TECHNIQUES USED IN PATIENTS WITH NORMAL AND ARTERIOSCLEROTIC HEARTS AFTER INFARCTION. JAMA. 1960;173(11):1231–1233. doi:10.1001/jama.1960.73020290012012
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