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Nitrates: the problem of tolerance


Nitrates are widely used for the prophylaxis and treatment of angina pectoris and for the treatment of heart failure. Their beneficial effects are attributed to their potent vasodilator action on veins and arteries. They all produce similar effects, but their duration of action and potency differ according to structure and formulation.1 All nitrates can induce tolerance - an attenuation of their effects against angina and heart failure. We review here how this occurs, whether it matters, and how it affects their use.

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