Changes in heart rate under the influence of nitroglycerin in patients with stable angina pectoris of functional classes III and IV in combination with hypertension

Background. For many years, nitroglycerin has been the primary treatment for coronary pain in patients with angina pectoris, but its effect on heart rate is not fully understood.

Aim. To study the change in heart rate under the influence of nitroglycerin in patients with stable angina pectoris of functional classes III and IV in combination with hypertension.

Material and methods. The study included 122 men aged 40 to 65 years (mean age 58.42±5.8 years) with stable exertional angina of functional classes III and IV in combination with hypertension. A rhythmocardiographic study was performed with simultaneous recording of an electrocardiogram initially and 5 minutes after sublingual administration of nitroglycerin. The number of ventricular and supraventricular extrasystoles was assessed in each vegetative test (background, Valsalva, Ashner, active orthostatic and with physical activity) initially and after taking nitroglycerin. To evaluate the compared values, the mean value, standard error of the mean, maximum, minimum, frequencies, Wilcoxon criteria, Pearson's χ2 were calculated.

Results. Under the influence of sublingual intake of nitroglycerin, the number of supraventricular extrasystoles decreased in approximately 7% of patients in the background sample, in the rest, an increase prevailed in 7.4–9.0% of patients, depending on vegetative test. At the same time, the number of ventricular extrasystoles decreased in the background (in 13.9% of patients) and orthostatic (in 9.8%) samples, in the rest, their growth prevailed in 9–17% of patients, depending on vegetative test.

Conclusion. Sublingual use of nitroglycerin leads to an increase in the number of supraventricular extrasystoles, as well as a variable effect on ventricular extrasystoles, depending on the vegetative test performed.