Topical nitroglycerin for ischemic heart disease

Abstract

THE MAINSTAY of medical management of angina pectoris continues to be β-blocking agents and nitrates. Used initially in the treatment of Raynaud's disease,¹nitroglycerin ointment was first introduced for the treatment of angina pectoris in 1955, but at that time it did not receive widespread clinical application. In the past few years, topical nitroglycerin has enjoyed a revival as a therapeutic agent, especially for patients with unstable or nocturnal angina. We compared the physiological and clinical effectiveness of sublingual and topical nitroglycerin (Nitrol Ointment) when used in patients with ischemic heart disease. <h3>Mechanism of Action of Nitroglycerin</h3> Myocardial ischemia is the result of an imbalance between myocardial oxygen demand and myocardial oxygen supply. Although nitroglycerin has been shown to be clinically effective in the therapy of this condition, its exact mechanism of action is still uncertain. At the present time it seems prudent to consider that nitroglycerin alters the