Role of high-dose intravenous nitrates in hypertensive acute heart failure

Wang, Kellie; Samai, Kathryn

doi:10.1016/j.ajem.2019.06.046

Cited by 22 publications

(12 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nitrate drugs are one of the oldest cardiovascular drugs in clinical practice. They were initially used to prevent and treat angina pectoris and gradually applied to the treatment of HF and hypertension [73] . The primary mechanism of action is that nitrate esters can be converted into NO by the action of a series of enzymes; this then activates intracellular signal transduction pathways, reducing the concentration of calcium ions in smooth muscle cells, and relaxing smooth muscle [74] .…”

Section: Common Cardiovascular Drugs In Depressionmentioning

confidence: 99%

Association between common cardiovascular drugs and depression

Tao

Ren

Zhang

2021

Chinese Medical Journal

View full text Add to dashboard Cite

Objective:Cardiovascular diseases are associated with an increased risk of depression, but it remains unclear whether treatment with cardiovascular agents decreases or increases this risk. The effects of drugs on individual usage are also often unknown. This review aimed to examine the correlation between depression and common cardiovascular drugs, develop more potent interventions for depression in cardiovascular patients, and further research on the bio-behavioural mechanisms linking cardiovascular drugs to depression.Data sources:The data in this review were obtained from articles included in PubMed, EMBASE, and Web of Science.Study selection:Clinical trials, observational studies, review literature, and guidelines about depression and cardiovascular drugs were selected for the article.Results:We systematically investigated whether the seven most used cardiovascular drugs were associated with altered risk of incident depression in this literature review. Statins have been proven to have antidepressant effects. Some studies believe angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blocker (ARB) can exert an antidepressant influence by acting on the renin-angiotensin system, but further clinical trials are needed to confirm this. Beta-blockers have previously been associated with depression, but the current study found no significant association between beta blockers and the risk of depression. Aspirin may have antidepressant effects by suppressing the immune response, but its role as an antidepressant remains controversial. calcium channel blockers (CCBs) can regulate nerve signal transduction by adjusting calcium channels, but whether this effect is beneficial or harmful to depression remains unclear. Finally, some cases have reported that nitrates and diuretics are associated with depression, but the current clinical evidence is insufficient.Conclusions:Statins have been proven to have antidepressant effect, and the antidepressant effects of ACEIs/ARB and aspirin are still controversial. CCBs are associated with depression, but it is unclear whether it is beneficial or harmful. No association has been found with β-blockers, diuretics, and nitrates.

show abstract

Section: Common Cardiovascular Drugs In Depressionmentioning

confidence: 99%

Association between common cardiovascular drugs and depression

Tao

Ren

Zhang

2021

Chinese Medical Journal

View full text Add to dashboard Cite

show abstract

“…It has previously been demonstrated that high-dose bolus intravenous NTG for acute, cardiogenic pulmonary edema is associated with lower rates of ICU admission and ETI 4 and shorter lengths of stay in the hospital. Based on published reports, most patients are rapidly stabilized on lower doses of (ie, 1-2 mg NTG) 5 with the highest reported total dose given over a short time period of 20 mg. 4 For the patient presented in this case report, these doses were not sufficient, and intravenous bolus doses were quickly escalated up to 16 mg at a time for a NTG total of 56 mg given over 41 minutes (not including the continuous infusion drip that provided another ∼3 mg). In this case, use of high dose intravenous NTG was safe and successful in a patient with acute cardiogenic pulmonary edema and markedly elevated BP.…”

Section: Discussionmentioning

confidence: 99%

“…7 Current recommendations for high dose bolus intravenous NTG are to use 2-mg doses given every 3 to 5 minutes. Although such an approach may, in combination with titrated drips, have a higher rate of hypotension as a complication, 5 this is very rare, particularly in African-Americans with poor baseline BP control.…”

Section: Discussionmentioning

confidence: 99%

“…JACEP Open published by Wiley Periodicals LLC on behalf of American College of Emergency Physicians and endotracheal intubation (ETI), improve BP, and reduce myocardial injury. 4,5 This approach has also been shown to shorten hospital length of stay and decrease intensive care unit admissions. 4 When given sublingually and transdermally, nitrate doses up to 121 mg have been given over 48 hours and shown to be helpful and safe.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Ultra‐high dose intravenous nitroglycerin in an ESRD patient with acutely decompensated heart failure

et al. 2021

View full text Add to dashboard Cite

show abstract

“…35,40 It has been proposed that high-dose nitrate therapy may be particularly helpful and well tolerated in patients presenting with hypertensive HF. 43 The National Institute for Health and Care Excellence (NICE) performed a systematic review comparing intravenous nitroglycerin with placebo in patients with ADHF in the UK, and found no good quality evidence of improvement in dyspnea with nitrates. 38 Potential adverse effects of nitroglycerin include hypotension and headache.…”

Section: Vasodilatorsmentioning

confidence: 99%

Medical management of decompensated heart failure in adult patients: Part 1: Definition and medical management

Elmassry¹,

Rahman²,

Paz³

et al. 2020

The Chronicles

View full text Add to dashboard Cite

Acute decompensated heart failure (ADHF) is the leading cause of hospitalization in patients older than 65 years. It continues to increase in prevalence and is associated with significant mortality and morbidity including frequent hospitalizations. The American Heart Association is predicting that more than 8 million Americans will have heart failure by 2030 and that the total direct costs associated with the disease will rise from $21 billion in 2012 to $70 billion in 2030. The definition of ADHF has important limitations, and its management differs significantly from that of chronic heart failure. Although many large, randomized, controlled clinical trials have been conducted in patients with chronic heart failure, it was not until recently that more studies began to address the management of ADHF. The mainstay of ADHF management involves identification of precipitating factors, oxygen supplementation, sodium and fluid restriction, and diuresis. The phenomenon of diuretic resistance is a significant obstacle to relief of congestion and is a field of active investigation. Other important adjuncts to treatment include noninvasive ventilation, inotropes, vasopressors, nitrates, opiates, and vasopressin receptor antagonists. In this review, we will discuss the terminology and classification of ADHF, and review the multiple modalities and strategies available for the management of this disorder. Keywords: heart failure, medical management, complications, devices, palliative care

show abstract

Role of high-dose intravenous nitrates in hypertensive acute heart failure

Cited by 22 publications

References 18 publications

Association between common cardiovascular drugs and depression

Association between common cardiovascular drugs and depression

Ultra‐high dose intravenous nitroglycerin in an ESRD patient with acutely decompensated heart failure

Medical management of decompensated heart failure in adult patients: Part 1: Definition and medical management

Contact Info

Product

Resources

About