Nitrate tolerance. State of the art — Chairman's summary

Abstract

The development of tolerance to the effects of nitrates is well documented in the literature. It can be induced and rapidly reversed with all types of nitrates and it is more pronounced in the arterial as compared to the venous circulation. Crosstolerance between different nitrates exists. Furthermore, tolerance seems more related to high and continuous plasma concentrations and may possibly be avoided by intermittent dosing. The importance of such factors as patient selection, type of nitrate preparation, duration of therapy, the significance of target organs, methods of evaluating the development of nitrate tolerance as well as a summary of the discussions during the workshop is presented.

Effects of Nitric Oxide and Noradrenergic Activation in the Posterior Hypothalamus on Arterial Pressure Tolerance to Nitroglycerin in Rats

“…response is manifested as partial or complete attenuation of vasodilator effects. 1,4 Nitrate tolerance develops rapidly and may be reversed within 12 hours [5][6][7] and the mechanism of tolerance remains poorly defined and is still controversial. It has been demonstrated that tolerance to the hypotensive action of sodium nitroprusside (SNP) occurs rarely and cross-tolerance between organic nitrates and SNP does not appear to exist.…”