Comparison of the vasodilatory effects of sodium nitroprusside vs. nitroglycerin

Abstract

The vasodilatory mechanism of Nntroglycerin (NTG) is similar to sodium nitroprusside (SNP) in regard to action on guanosine 3'5'-monophosphate (cyclic GMP) via nitric oxide. However, it is unknown whether NTG can achieve the same magnitude of vasodilation in the forearm as SNP. Therefore, the purpose of the study was to evaluate the differences in forearm blood flow (FBF) and forearm vascular conductance (FVC) during escalating infusions of NTG vs. SNP at similar concentration doses and rates. We measured FBF using venous occlusion plethysmography (VOP) and Doppler ultrasound in eight young, healthy participants (mean age = 28 ± 2 yr) during four forearm volume (FAV)-specific doses (0.25, 0.5, 1, and 2 µg·100 ml FAV^-1·min^-1) of SNP and NTG infused via a brachial artery catheter. There was a significant difference in FVC of SNP vs. NTG only at the higher doses, as measured by VOP (14.9 ± 1.4 and 18.3 ± 1.5 vs. 11.6 ± 1.2 and 12.5 ± 1.2 ml/dl FAV^-1·min^-1·100 mmHg^-1). FVC as measured by Doppler ultrasound unadjusted for FAV was significantly different at the lowest and the higher two doses of SNP compared with NTG (202.1 ± 25.8, 329.4 ± 46.7, and 408 ± 63.5 vs. 142.9 ± 22.4, 217.2 ± 18.8, and 247.5 ± 18.2 ml·min^-1·100 mmHg^-1). SNP induces significantly higher vasodilatory actions compared with NTG. However, NTG is comparable in eliciting equivalent vasodilator effects to SNP during low concentration doses when measured by VOP. Importantly, for forearm pharmacology studies, NTG can elicit marked endothelium-independent forearm vasodilation.NEW & NOTEWORTHY We compared the vasodilatory capacities of NTG vs. SNP at similar concentration doses and rates into the forearm. Based on the results of the study, it may be feasible to use intra-arterial NTG as a measure of endothelial-independent vasodilator in research studies. However, NTG dosing may need to be higher if used as an endothelial-independent vasodilator due to significant differences in the vasodilatory effects during higher doses of SNP compared with NTG.

Keywords: Doppler ultrasound; vasodilators; venous occlusion plethysmography.

Fig. 1.

Forearm vascular conductance (FVC) using venous occlusion plethysmography (VOP) during sodium nitroprusside (SNP) and nitroglycerin (NTG) infusion. #P < 0.05, significant interaction between doses; *P < 0.05, significant difference between SNP and NTG. FAV, forearm volume.

Fig. 2.

Forearm vascular conductance (FVC) using venous occlusion plethysmography during sodium nitroprusside (SNP) and nitroglycerin (NTG) infusion. #P < 0.05, significant interaction between doses; *P < 0.05, significant difference between SNP and NTG. FAV, forearm volume.

Fig. 3.

A [venous occlusion plethysmography (VOP)] and B (Doppler ultrasound): representative slopes of one of the participants for forearm vascular conductance (FVC) during sodium nitroprusside (SNP) and nitroglycerin (NTG). C and D: FVC slope during SNP and NTG. #P < 0.05, significant difference between SNP and NTG.