title: Chronic treatment and tolerance with high doses of isosorbide dinitrate in a slow release form in patients with angina pectoris.
abstract: Nine men with angiographically proven coronary sclerosis and a reproducible ischemic response on the exercise ECG were treated for 9 weeks with a dose of 180-240 mg isosorbide dinitrate slow release (ISDN sr) daily. In the week before the beginning of the treatment (week 1) and in the week after its conclusion (week 10), exercise tests were carried out before and 1 and 3 h after administration of 60 mg ISDN sr or placebo. This part of the investigation was double-blind, cross-over and randomized. In an open study carried out during the 2nd-9th weeks, exercise tests were carried out weekly before and 1 and 3 h after the usual morning dose of 60 mg ISDN sr. The interval between the morning exercise and the last evening dose was 8-10 h. Exercise duration and required level of exertion remained constant during the entire study. The sum of ischemic ST-segment depression during and after exercise, heart rate (ECG) and blood pressure (RR) were all measured. Both before and after the period of treatment 60 mg ISDN sr produced a significant reduction in ST-segment depression after 1 and 3 h. During the treatment phase no significant improvement in comparison to controls could be observed from the 7th week onward. However, even in controls the ST-segment depression was less in the 8th and 9th weeks than during the first few weeks.(ABSTRACT TRUNCATED AT 250 WORDS)
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000188:drug therapy*; D003692:Delayed-Action Preparations; D004361:Drug Tolerance; D005080:Exercise Test; D006801:Humans; D007548:Isosorbide Dinitrate / Q000008:administration & dosage* / Q000494:pharmacology; D008297:Male; D008875:Middle Aged
chemical_list: D003692:Delayed-Action Preparations; D007548:Isosorbide Dinitrate