Abstract
Nitrates have been used for more than 100 years for the treatment of coronary heart disease [1]. Their fundamental importance in the treatment of various stages of coronary insufficiency has been confirmed in numerous studies [2, 3]. The optimum dosage and dosage intervals are, however, still disputed because of development of tolerance [4, 5]. In contrast, calcium channel blockers have been used for the treatment of coronary heart disease for only about 10 years. Their precise therapeutic value in the different types of patients with coronary artery disease, especially in comparison with nitrates, has not so far been finally defined. Both groups of drugs exert their anti-anginal effects in patients with stable, reproducible, exercise-induced angina predominantly by reduction of the myocardial oxygen requirement. Nitrates reduce primarily the preload of the heart, whilst calcium antagonists like verapamil tend to reduce the afterload by reducing the peripheral vascular resistance. They have an additional negative inotropic effect [6–11].
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References
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Wiechmann, H.W., Lenga, P., Odenthal, H., Überbacher, H.J. (1987). Haemodynamic and Anti-Ischaemic Effects of Isosorbide 5-Mononitrate and Verapamil. In: Julian, D.G., Rittinghausen, R., Überbacher, H.J. (eds) Mononitrate II. International Boehringer Mannheim Symposia. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-72689-7_25
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DOI: https://doi.org/10.1007/978-3-642-72689-7_25
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