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Tolerance in Patients with Coronary Heart Disease Under Chronic Treatment with Isosorbide Dinitrate?

  • Conference paper
Nitrates and Nitrate Tolerance in Angina Pectoris

Abstract

The phenomenon of tolerance was described for the first time by Stewart in 1888 (32, 33). He wrote about a patient, in whom it took 20 grains of nitroglycerin to produce the same hypotensive effect as was initially achieved with 1/100 grain. Subsequently, a number of reports were published concerning the diminishing effects of nitrates during chronic treatment in respect to heart rate, blood pressure, and headache (5, 11, 12, 30, 35). On the other hand, withdrawal symptoms after chronic use of nitrates were seen (15, 27). The experiences with workers in dynamite factories are well known (9, 17, 20, 34). Definitions of tolerance, tachyphylaxis, and so on are given in Table 1. The main problem in chronic treatment with nitrates is whether tolerance occurs or not. We have carried out three studies and started a fourth with a view to providing an answer to this question.

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Authors and Affiliations

  1. Medizinische Klinik I, Stadtkrankenhaus, Leimenstraße 20, D-6450, Hanau 1, Germany

    Prof. Dr. H.-J. Becker

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  1. Prof. Dr. H.-J. Becker
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  2. R. Meudt
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  3. S. Kretschmer
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  4. H. D. Hüwer
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Editors and Affiliations

  1. Abteilung für Kardiologie, Zentrum Innere Medizin, Theodor-Stern-Kai 7, D-6000, Frankfurt/Main 70, Germany

    M. Kaltenbach  & G. Kober  & 

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© 1983 Dr. Dietrich Steinkopff Verlag, GmbH & Co. KG, Darmstadt

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Becker, HJ., Meudt, R., Kretschmer, S., Hüwer, H.D. (1983). Tolerance in Patients with Coronary Heart Disease Under Chronic Treatment with Isosorbide Dinitrate?. In: Kaltenbach, M., Kober, G. (eds) Nitrates and Nitrate Tolerance in Angina Pectoris. Steinkopff. https://doi.org/10.1007/978-3-642-85323-4_12

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  • DOI: https://doi.org/10.1007/978-3-642-85323-4_12

  • Publisher Name: Steinkopff

  • Print ISBN: 978-3-642-85325-8

  • Online ISBN: 978-3-642-85323-4

  • eBook Packages: Springer Book Archive

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