Nitroglycerin, stroke and hypertension: a word of caution

The ENOS trial investigators performed a large multicenter trial investigating the role of a daily nitroglycerine patch in hypertensive patients with an acute stroke. (1) The reasoning for the choice of this agent in patients with an acute stroke is puzzling. Nitroglycerine is a potent veno-dilator and only in high doses does this drug reduce arterial tone. (2) This agent reduces blood pressure predominantly by reducing venous return and cardiac output. (2) It would appear counter-institutive to use a drug which reduces cardiac output, and therefore organ blood flow, in patients who have suffered an acute ischemic stroke. Rashid and…
Nitroglycerin, stroke and hypertension- a word of caution