Nitrate therapy in the elderly

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Changes in the heart and blood vessels with age alter the response of the cardiovascular system to pharmacologic agents. Nitrate plasma half-life is longer and volume of distribution is larger in older persons. Apparently, these pharmacokinetic differences in older persons lead to increased venous smooth muscle responsivity to nitrates which, in turn, leads to greater reductions in central venous and pulmonary arterial pressures after nitrate administration. This is probably the explanation for the greater frequency of nitrate-induced severe hypotension and bradycardia in elderly patients with myocardial infarction compared with younger patients. Clinicians should be cognizant of the changes in the cardiovascular system which occur with age that sensitize the elderly patient to the action of organic nitrates. Initial dosages of nitrates should accordingly be less than in younger patients.

Original languageEnglish (US)
JournalThe American journal of cardiology
Volume65
Issue number21
DOIs
StatePublished - Jun 4 1990
Externally publishedYes

Fingerprint

Nitrates
Cardiovascular System
Therapeutics
Controlled Hypotension
Bradycardia
Smooth Muscle
Blood Vessels
Half-Life
Arterial Pressure
Pharmacokinetics
Myocardial Infarction
Lung

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Nitrate therapy in the elderly. / Alpert, Joseph S.

In: The American journal of cardiology, Vol. 65, No. 21, 04.06.1990.

Research output: Contribution to journalArticle

@article{805e612929a042098da7d3f57bee1aea,
title = "Nitrate therapy in the elderly",
abstract = "Changes in the heart and blood vessels with age alter the response of the cardiovascular system to pharmacologic agents. Nitrate plasma half-life is longer and volume of distribution is larger in older persons. Apparently, these pharmacokinetic differences in older persons lead to increased venous smooth muscle responsivity to nitrates which, in turn, leads to greater reductions in central venous and pulmonary arterial pressures after nitrate administration. This is probably the explanation for the greater frequency of nitrate-induced severe hypotension and bradycardia in elderly patients with myocardial infarction compared with younger patients. Clinicians should be cognizant of the changes in the cardiovascular system which occur with age that sensitize the elderly patient to the action of organic nitrates. Initial dosages of nitrates should accordingly be less than in younger patients.",
author = "Alpert, {Joseph S}",
year = "1990",
month = "6",
day = "4",
doi = "10.1016/0002-9149(90)91306-Q",
language = "English (US)",
volume = "65",
journal = "American Journal of Cardiology",
issn = "0002-9149",
publisher = "Elsevier Inc.",
number = "21",

}

TY - JOUR

T1 - Nitrate therapy in the elderly

AU - Alpert, Joseph S

PY - 1990/6/4

Y1 - 1990/6/4

N2 - Changes in the heart and blood vessels with age alter the response of the cardiovascular system to pharmacologic agents. Nitrate plasma half-life is longer and volume of distribution is larger in older persons. Apparently, these pharmacokinetic differences in older persons lead to increased venous smooth muscle responsivity to nitrates which, in turn, leads to greater reductions in central venous and pulmonary arterial pressures after nitrate administration. This is probably the explanation for the greater frequency of nitrate-induced severe hypotension and bradycardia in elderly patients with myocardial infarction compared with younger patients. Clinicians should be cognizant of the changes in the cardiovascular system which occur with age that sensitize the elderly patient to the action of organic nitrates. Initial dosages of nitrates should accordingly be less than in younger patients.

AB - Changes in the heart and blood vessels with age alter the response of the cardiovascular system to pharmacologic agents. Nitrate plasma half-life is longer and volume of distribution is larger in older persons. Apparently, these pharmacokinetic differences in older persons lead to increased venous smooth muscle responsivity to nitrates which, in turn, leads to greater reductions in central venous and pulmonary arterial pressures after nitrate administration. This is probably the explanation for the greater frequency of nitrate-induced severe hypotension and bradycardia in elderly patients with myocardial infarction compared with younger patients. Clinicians should be cognizant of the changes in the cardiovascular system which occur with age that sensitize the elderly patient to the action of organic nitrates. Initial dosages of nitrates should accordingly be less than in younger patients.

UR - http://www.scopus.com/inward/record.url?scp=0025280891&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025280891&partnerID=8YFLogxK

U2 - 10.1016/0002-9149(90)91306-Q

DO - 10.1016/0002-9149(90)91306-Q

M3 - Article

C2 - 2112335

AN - SCOPUS:0025280891

VL - 65

JO - American Journal of Cardiology

JF - American Journal of Cardiology

SN - 0002-9149

IS - 21

ER -