Summary
Transdermal nitroglycerin (Nitroderm TTS 5) and a placebo were applied to 10 healthy male volunteers for 10 days. Before the first application and 6, 24, 48, 96, and 240 h thereafter, the viscosity of plasma and whole blood was measured and the packed-cell volume determined. During nitroglycerin application, the viscosity of plasma and whole blood was significantly diminished, and after 10 days it averaged 5% below the initial value. The greater the initial viscosity, the more marked was the druginduced reduction: in 5 subjects with plasma and whole-blood viscosities near the lower limit of the normal range, there was only a temporary decrease and the values reverted to their initial levels after 4 days; in the other 5 subjects, whose whole-blood viscosities were near the upper limit of the normal range, a 10% reduction was still demonstrable after 10 days. In those subjects all values measured throughout the 10-day observation period were significantly below the initial values. The haematocrit readings followed the same pattern as the alterations in viscosity. It can be assumed, therefore, that the decrease in viscosity induced by nitroglycerin results from “internal haemodilution”. The clinical relevance of the changes observed is discussed. The improvement in the rheological properties of the blood may contribute to the anti-anginal effect of Nitroderm TTS.
Similar content being viewed by others
References
Folkow B, Mellander S (1964) Veins and venous tone. Am Heart J 68: 397–408
Messmer K (1976) Les effets de l'hémodilution sur les propriétés rhéologiques du sang et sur l'oxygénation des tissues. Anesth Analg Réan 33: 509–520
Murray JF, Escobar E (1968) Circulatory effects of blood viscosity: Comparison of methemoglobinemia and anemia. J Appl Physiol 25: 594–599
Chapler CK, Cain SM (1981) Blood flow and O2 uptake in dog hindlimb with anemia, norepinephrine, and propranolol. J Appl Physiol 51: 565–570
Thomas DJ, Marshall J, Ross Russell RW, Wetherley-Mein G, du Boulay GH, Pearson TC, Symon L, Zilkha E (1977) Effect of haematocrit on cerebral blood-flow in man. Lancet 2: 941–943
Dormandy JA, Yates CJP, Berent GA (1981) Clinical relevance of blood viscosity and red cell deformability including newer therapeutic aspects. Angiology 32: 236–242
Yates CJP, Andrews V, Berent A, Dormandy JA (1979) Increase in leg blood-flow by normovolaemic haemodilution in intermittent claudication. Lancet 2: 166–168
Kannel WB, Gordon T, Wolf PA, McNamara P (1972) Hemoglobin and the risk of cerebral infarction: The Framingham study. Stroke 3: 409–420
Sorlie PD, Garcia-Palmieri MR, Costas R, Havlik RJ (1981) Hematocrit and risk of coronary heart disease: The Puerto Rico Heart Health Program. Am Heart J 101: 456–461
Dormandy JA, Matrai A (1983) Assessment of pharmacological agents with a hemorheological action. Ann NY Acad Sci 416: 599–609
Stoltz JF (1981) Drugs affecting blood rheology — a review. Scand J Clin Lab Invest 41 [Suppl 156]: 287–290
van den Berg E, Haedicke C, Sqries B, Stangel W, Altmann S, Hartmann F (1983) Klinik und Therapie des Hyperviskositätssyndroms. VASA 12 [Suppl 10]: 1–37
Dufaux J, Quemada D, Mills P (1980) Determination of rheological properties of red blood cells by Couette viscometry. Rev Phys Appl 15: 1367–1374
Azelvandre F, Mandret G, Peters A (1979) Rheological behaviour of stored blood cells. Biorheology 16: 435–446
Dufaux J, Quemada D, Mills P, Lambert M (1980) Rhéogrammes caractéristiques de sangs pathologiques. J Malad Vasc 5: 135–137
Spinelli FR, Meier ChD (1974) Measurement of blood viscosity. Biorheology 11: 301–306
Bureau M, Healy JC, Bourgoin D, Joly M (1978) Etude expérimentale in vitro du comportement rhéologique du sang en régime transitoire à faible vitesse de cisaillement. Rheol Acta 17: 612–625
Bayliss LE (1962) The rheology of blood. In: Hamilton WF, Dow P (eds) Handbook of physiology, section 2: Circulation, vol 1. Am Physiol Soc, Washington, DC, pp 137–150
CRC Handbook of chemistry and physics. Weast RC, Astle MJ (eds) 63rd Edition 1982–1983, CRC Press Boca Raton, FL. p F-40
Gaehtgens P (1981) Distribution of flow and red cell flux in the microcirculation. Scand J Clin Invest 41: 83–87
Hossmann V, Wegener H, Wegener B, Saborowski F, Cäsar K (1981) Hemorheological and hemodynamic effects of ISDN in essential hypertension and obliterative arterial disease. In: Lichtlen PR, Engel HJ, Schrey A, Swan HJC (eds) Nitrates III. Springer-Verlag, Berlin Heidelberg, pp 263–270
Lipowsky HH, Usami S, Chien S (1980) In vivo measurements of “apparent viscosity” and microvessel hematocrit in the mesentery of the cat. Microvasc Res 19: 297–319
Dintenfass L (1983) Action of drugs on the aggregation and deformability of red cells: Effect of ABO blood groups. Ann NY Acad Sci 416: 611–632
Dintenfass L, Julian DG, Miller GE (1966) Viscosity of blood in normal subjects and in patients suffering from coronary occlusion and arterial thrombosis. Am Heart J 71: 587–600
Nicolaides AN, Bowers R, Horbourne T, Kidner PH, Besterman EM (1977) Blood viscosity, red-cell flexibility, haematocrit, and plasma-fibrinogen in patients with angina. Lancet 2: 943–945
Jan K-M, Chien S, Bigger JT (1975) Observations on blood viscosity changes after acute myocardial infarction. Circulation 51: 1079–1084
Chmiel H, Effert S, Mathey D (1973) Rheologische Veränderungen des Blutes beim akuten Herzinfarkt und dessen Risikofaktoren. Dtsch Med Wochenschr 98: 1641–1646
Pfafferott C, Volger E (1983) Bedeutung der Fließeigenschaften des Blutes für die Mikrozirkulation. Dtsch Med Wochenschr 108: 1845–1851
Chmiel H, Störmer B (1972) Zur Rheologie des Blutes. Biomed Technik 5: 1–7
Larsson H, Odeberg H, Bohlin L (1983) Studies of blood viscosity with a newly constructed rotational viscometer which operates via a desk top computer. Scand J Clin Lab Invest 43: 493–502
Ehrly AM (1973) Verbesserung der Fließeigenschaften des Blutes: Ein neues Prinzip zur medikamentösen Therapie chronischer peripherer arterieller Durchblutungsstörungen. VASA 2 [Suppl 1]: 1–17
Ehrly AM (1979) The effect of pentoxifylline on the deformability of erythrocytes and on the muscular oxygen pressure in patients with chronic arterial disease. J Med 10: 331–338
Lowe GDO, Drummond MM, Lorimer AR, Hutton I, Forbes CD, Prentice CRM, Barbenel JC (1980) Relation between extent of coronary artery disease and blood viscosity. Br Med J 280: 673–674
Dintenfass L, Lake B (1977) Blood viscosity factors in evaluation of submaximal work output and cardiac activity in men. Angiology 28: 788–798
Lake B, Dintenfass L (1975) Blood viscosity in the “ischaemic” exercise E. C. G. Lancet 2: 1092
Benda L, Klösel W, Redtenbacher L, Spiess A, Zenz W (1976) Fibrinolyse und Antikoagulation bei schwerer Angina pectoris. Wien Med Wochenschr 126: 1–9
Gordon RJ, Snyder GK, Tritel H, Taylor WJ (1974) Potential significance of plasma viscosity and hematocrit variations in myocardial ischemia. Am Heart J 87: 175–182
Di Perri T, Forconi S, Guerrini M, Rossi C, Pieragalli D (1979) Blood viscosity in the different stages of ischemic heart disease, angina pectoris and myocardial infarction. In: Mason DT, Neri Serneri GG, Oliver MF (eds) Proceedings Vol I, Florence International Meeting on Myocardial Infarction. Excerpta Medica, Amsterdam, pp 349–353
Strauer BE (1981) Koronare Mikrozirkulationsstörungen. Klin Wochenschr 59: 1125–1137
Strauer BE, Volger E (1981) Koronare Mikrozirkulationsstörungen — ein rheologisches Problem? Verh Dtsch Ges Inn Med 87: 1327–1341
Strauer BE (1981) Rheologische Ursachen der Koronarinsuffizienz. Dtsch Med Wochenschr 106: 1487–1490
Strauer BE (1981) Pathogenese und Klinik koronarer Mikrozirkulationsstörungen. Münch Med Wochenschr 123: 84–88
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Brügger, W., Imhof, P., Müller, P. et al. Effect of nitroglycerin on blood rheology in healthy subjects. Eur J Clin Pharmacol 29, 331–336 (1985). https://doi.org/10.1007/BF00544090
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00544090