Cardiovasc Drugs Ther. 1997 May;11 Suppl 1:213-8.
Thadani U. Department of Medicine, University of Oklahoma, Health Sciences Center, Oklahoma City 78104, USA.
Oral nitrates: more than symptomatic therapy in coronary artery disease?
The predominant venodilator properties of the nitrates and their augmentation of collateral coronary blood flow to the ischemic myocardium endows them with some ideal characteristics for treating myocardial ischemic syndromes. Additional efficacy stems from the ability of the nitrates to replenish the deficient endothelium-derived relaxing factor (EDRF), nitric oxide (NO), in patients with coronary heart disease and also to inhibit platelet aggregation. In stable angina pectoris, the antianginal and antiischemic effects of oral nitrates are well established. Continuous administration of nitrates may lead to tolerance of their clinical efficacy. Recent studies, however, have demonstrated that when used in recommended doses, tolerance can be avoided during long-term treatment with oral nitrates without provocation of anginal attacks during periods of low nitrate levels at night and early hours of the morning. Thus, prolonged treatment with an asymmetric twice-daily regimen of immediate-release isosorbide-5-mononitrate in patients with stable angina pectoris does not give rise to clinical tolerance, prolongs exercise duration, and delays the onset of myocardial ischemia. In unstable angina pectoris, nitrates rapidly relieve chest pain and ameliorate the electrocardiographic signs of myocardial ischemia. In patients with acute myocardial infarction, early treatment with nitrates prevents left ventricular dilatation, improves pumping function, and reduces the risk of ventricular arrhythmias. In patients with chronic heart failure, oral nitrates improve exercise tolerance and, when given in combination with the systemic arterial dilator hydralazine, extend survival. Meta-analysis of published studies has demonstrated that both intravenous and oral nitrates reduced infarct size and morbidity and mortality in patients with acute myocardial infarction. In the ISIS 4 post-infarction study, isosorbide-5-mononitrate 60 mg once daily was not superior to placebo in reducing mortality risk. However, in the GISSI 3 study, the combination of nitrates with an angiotensin-converting enzyme (ACE) inhibitor reduced mortality risks by 17% in patients with acute myocardial infarction. In both the ISIS 4 and GISSI 3 studies, 62% and 57% of the patients in the placebo and control groups, respectively, were treated with nitrates for control of rest angina, myocardial ischemia, and or left ventricular failure symptoms, and this widespread use of open-label nitrates in the control groups may have diluted the true beneficial effects of nitrates in both studies. Taken together, these many studies with oral nitrate treatment in coronary heart disease and heart failure clearly emphasize that these drugs are safe and play more than a symptomatic role in the management of patients with acute and chronic ischemic syndromes due to coronary artery disease.
J Cardiovasc Pharmacol. 1999 Aug;34 Suppl 2:S15-20; discussion S29-31.
Darius H. Department of Medicine II, Johannes Gutenberg University, Mainz, Germany. darius@2-med.klinik.uni-mainz.de
Role of nitrates for the therapy of coronary artery disease patients in the years beyond 2000.
Vasodilator therapy with nitrates has been used for almost a century to bring relief to patients suffering from angina. The acute anti-ischemic effects of nitro-vasodilators for the treatment and prevention of anginal attacks is unquestioned. In addition, nitrates are administered in order to reduce symptomatic and silent ischemic episodes, in patients with proven coronary heart disease who exert ST segment alterations on Holter monitoring. The reduction in total ischemic burden may result in an improved prognosis with regard to infarct prevention and possible prevention of deterioration of left ventricular function due to repetitive episodes of myocardial ischemia. In patients with unstable angina, administration of nitrates significantly diminishes ischemic episodes and reduces the number of clinically symptomatic anginal attacks. The prevention of left ventricular dilatation in patients within the first few days and months following acute myocardial infarction may be due to the reduced preload. In patients with heart failure, preload reduction with nitrates and afterload reduction with hydralazine was tested versus angiotensin converting enzyme (ACE) inhibitors. However, unfortunately, very few data are available concerning the combination therapy of ACE inhibitors and nitrates in heart failure and following acute myocardial infarction. Long-term continuous administration of high doses of nitrates may cause nitrate tolerance, thus reducing the vasodilator potency of these drugs. Since nitrates were introduced into medical therapy many decades before randomized controlled trials were performed, and evidence-based medicine became the basic principal for medical therapy, there are still indications and situations where the full therapeutic potential of nitrates is not being fully appreciated. During recent decades, other anti-ischemic drugs, i.e., beta-receptor agonists and calcium channel blockers, were introduced into the clinical setting and contributed to an optimized therapy for patients with coronary heart disease. Nevertheless, due to their proven and unsurmounted symptomatic efficacy, nitrates will remain one of the cornerstones of acute and long-term therapy of patients with coronary heart disease far beyond the year 2000.
|
Thread: Creatine Nitrate, any good?
-
06-25-2010, 07:34 AM #61~
Wherever progression lacks.... regress can be found in abundance.
-
06-25-2010, 03:40 PM #62
-
06-25-2010, 04:08 PM #63
- Join Date: Oct 2004
- Location: County Donegal, Ireland
- Posts: 8,160
- Rep Power: 51204
Assuming you are interested, the drugs of choice for CHF are ACE inhibitors and diuretics. Feel free to consult AccessMedicine for more information. This website also details some treatment strategies:
http://www.emedicinehealth.com/conge...e/page9_em.htm
Nevertheless, the concept of 'baby aspirin' in conjunction with creatine was a joke which most people who read this thread immediately 'got.' To which you responded:
NO HYPE: "Are you seriously comparing the pharmacokinetics of asprin, with a mere terminal half-life of 0.4 to 2.1 hours [1], to that of nitrates?".
I then explained the difference between a clearance half-life and a biological half-life which launched you on a tirade about 'organic nitrates' in CHF. There is a difference between defending ones pride and being militantly ignorant.
Furthermore, the entire premise of this argument is sementic in nature. Creatine nitrate is a salt - not an ester - so its consumption leads to an additive effect, which I explained on the first page.Last edited by neuron; 06-25-2010 at 05:26 PM.
twitter: @bullexinferis
-
06-25-2010, 04:30 PM #64
- Join Date: Oct 2004
- Location: County Donegal, Ireland
- Posts: 8,160
- Rep Power: 51204
While vasodilation is likely, there is no evidence that nitrates will enhance the absorption of creatine. Similarly, after intracellular creatine-phosphate levels are saturated, the absorption/kinetic parameter is quite irrelevant.
And...again...I'm not saying a creatine nitrate salt is wortheless, but simply that there is no empirical evidence that it will outperform regular creatine. Other forms of creatine (CEE, creatine citrate), with very sound theory and massive amounts of anecdote, have been proven inferior to regular creatine. So to state that creatine nitrate is unequivocally superior to regular creatine is a large leap of faith.twitter: @bullexinferis
-
-
06-25-2010, 05:11 PM #65
-
06-26-2010, 02:15 AM #66Originally Posted by NO HYPE
Creatine monohydrate
Solubility in aqueous solution: 10-15 mg/ml
Creatine hydrochloride
Solubility in aqueous solution: 150 mg/ml
Originally Posted by NO HYPEOriginally Posted by neuron
Originally Posted by neuron
Originally posted by Bane:
Organic nitrates have also a great use in pharmacy as a permeation enhancer. That means that they increase intestinal absorption of not only the bonded molecule but ALL nutrients co ingested. They are even able to allow absorption of large macromolecules as insulin(4,5,6)!
4. Excellent absorption enhancing characteristics of NO donors for improving the intestinal absorption of poorly absorbable compound compared with conventional absorption enhancers.
Fetih G, Habib F, Katsumi H, Okada N, Fujita T, Attia M, Yamamoto A.
5. International Journal of Pharmaceutics 286 (2004) 89–97
Characterization of the influence of nitric oxide donors on intestinal absorption of macromolecules
Koichi Takahashia,∗, Nanako Numataa, Natsumi Kino****aa, Naoki Utoguchib, Tadanori Mayumic, Nobuyasu Mizunoa
6. Nitric oxide donors can enhance the intestinal transport and absorption of insulin and [Asu(1,7)]-eel calcitonin in rats.
Fetih G, Habib F, Okada N, Fujita T, Attia M, Yamamoto A.
Originally Posted by NO HYPEOriginally Posted by neuronLast edited by NO HYPE; 06-26-2010 at 03:11 AM.
~
Wherever progression lacks.... regress can be found in abundance.
-
06-26-2010, 06:21 AM #67
- Join Date: Oct 2004
- Location: County Donegal, Ireland
- Posts: 8,160
- Rep Power: 51204
Comparison of new forms of creatine in raising plasma creatine levels.
Differences in bioavailability are thought to be unlikely since absorption of CrM is already close to 100%. The small differences in kinetics are unlikely to have any effect on muscle creatine elevation during periods of creatine loading.
Nitrate induced vasodilation is dose-dependent. Don't kid yourself into thinking that every product with creatine nitrate has an effective dose.
You are actually making an incredibly large leap of logic (or a very ignorant stretch of the facts). Insulin is a polypeptide and has no intestinal mechanisms for absorption. Creatine, on the other hand, is an organic acid with very controlled mechanisms for intestinal entry. Secondly, the studies you reference are referring to NO-donors that spontaneously form nitric oxide in solution. Nitrates don't and they have nothing to do with the mechanism for increased paracellular transport (which is actually a bad thing). The full-texts of those articles are availabile free online so I'm not sure why you chose to make a fool out of yourself.
Wrong. Some NO-"donors" (which spontaneously form Nitric Oxide in solution) have demonstrated an ability to increase paracellular transport of some compounds by decreasing transepithelial electrical resistance. This is actually a detriment to the GI tract, and a property which nitrates do not possess.
http://journals.lww.com/shockjournal...arrier.10.aspx
4. Excellent absorption enhancing characteristics of NO donors for improving the intestinal absorption of poorly absorbable compound compared with conventional absorption enhancers.
Fetih G, Habib F, Katsumi H, Okada N, Fujita T, Attia M, Yamamoto A.
5. International Journal of Pharmaceutics 286 (2004) 89–97
Characterization of the influence of nitric oxide donors on intestinal absorption of macromolecules
Koichi Takahashia,∗, Nanako Numataa, Natsumi Kino****aa, Naoki Utoguchib, Tadanori Mayumic, Nobuyasu Mizunoa
6. Nitric oxide donors can enhance the intestinal transport and absorption of insulin and [Asu(1,7)]-eel calcitonin in rats.
Fetih G, Habib F, Okada N, Fujita T, Attia M, Yamamoto A.
I've already stated why altering the kinetics of creatine is irrelevant. Refer to those statements.twitter: @bullexinferis
-
06-26-2010, 08:09 AM #68Originally Posted by NO HYPE
The last sentence within that abstract "The small differences in kinetics are unlikely to have any effect on muscle creatine elevation during periods of creatine loading.", is rather conflicting, as it was stated that "differences in ka could not be detected due to the small number of blood samples taken during the absorption phase." The citation that you cited does nothing to nullify my comments reguarding significantly enhanced solubility resulting in faster absorption rates, and the lesser amounts of the parent compound needed to reach and/or maintain saturation.
I'm not kidding myself. Every product? As I indicated previously within this thread, you should be well aware of the fact that my comments pertained to C-BOL [as I have plenty of anecdotal evidence as to the significant degree of vasodilation that is elicited following the ingestion of C-BOL].
Originally Posted by NO HYPE
Medical Journal of Islamic Academy of Sciences 12:1, 5-11, 1999.
H. KOOSHAPUR, M. CHAIDEH
INTESTINAL TRANSPORT OF HUMAN INSULIN IN RAT
"In the case of oral administration of insulin, it is necessary to gain total confidence that such a large molecule can penetrate into the intestinal membrane. Various studies have shown that intact insulin can cross the small intestine of mice (3), rats (4-6), rabbits (7), dogs (8,9), and humans (10,11) but, bioavailability was poor due to proteolysis and/or to the barrier function of the intestinal membranes."
10. Diabetes, 17, no:10, 625-627, 1968.
Crane CW, Path MC and Luntz George RWN :
Absorption of insulin from the human small intestine.
11. J Pediatr, 79:1011-1014, 1971.
Balsam MJ, Holtzapple PG, Kaye R and Swell EM :
Instestinal absorption of insulin in patients with fibrocytic disease.
I will send Bane a PM reguarding this issue, seeing how he is the Pharmacist/formulator that made the statements in question.
Originally Posted by Bane
I had the utmost respect for you, up until now.~
Wherever progression lacks.... regress can be found in abundance.
-
-
06-26-2010, 08:26 AM #69
- Join Date: Oct 2007
- Location: Illinois, United States
- Age: 37
- Posts: 3,606
- Rep Power: 5614
no insults gentleman. Just scholarly debate
Sci-Fit Representative
www.scifitauthentic.com
forum.scifitauthentic.com
Any views or opinions presented are those of the author and do not represent the company. Representatives of Scifit are required not to make defamatory statements and not to infringe. The company will not accept any liability in respect of such communication, and the reps responsible will be personally liable for any damages or other liability arising.-
-
06-26-2010, 08:39 AM #70
-
06-26-2010, 08:44 AM #71
-
06-26-2010, 09:58 AM #72
Most of the info in this thread is over my head. That said, people are claiming they are getting insane pumps from the nitrates. Wasn't this the real world evidence the past five or so years with arginine as well?
"THE PEOPLE WHO MAKE THE GREATEST STRENGTH GAINS OVER TIME WILL MAKE THE GREATEST SIZE GAINS OVER TIME ACCORDING TO THEIR GENETIC POTENTIAL. If you're reading this and never get anywhere close to your ultimate strength levels (AT WHATEVER REP RANGE) you will never get to your utmost level of potential size." Dante Trudel
-
-
06-26-2010, 10:01 AM #73
- Join Date: Oct 2004
- Location: County Donegal, Ireland
- Posts: 8,160
- Rep Power: 51204
I've debunked every ignorant theory that you've posted in here and you keep posting abstracts. It is sad that people think this is a 'scholary debate' and not a one-sided obliteration.
Insulin is a polypeptide and is destroyed by the combination of gastric pH and enzymes. There is no mechanism for the absorption of insulin because if it is orally ingested, it is normally degraded into its basic components (amino acids, oligopeptides). Eliminating or decreasing the "transepithelial electrical resistance" (which NO donors and some pathogenic bacteria are capable of) is an inefficient and dangerous method for increasing [B]PARA-CELLULAR[b] transport (paracellular --> between two enterocytes) [the mechanism by which local nitric oxide decreases transepthelial electrical resistance is quite simple]. Nevertheless, NITRATES don't do this, so it is ONCE AGAIN a moot point.
Secondly, no one is arguing as to whether a creatine salt is more or less soluble than creatine monohydrate. From a practical standpoint, CrM's bioavailability is incredibly effective on its own, and thus increasing it even more (from say, 99% to 100%) does nothing to its potency, and is an irrelevant factoid. Furthermore, once intracellular creatine-phosphate stores are saturated, creatines bioavailaibity is absolutely irrelevant. Hopefully you understand by now that the nitrate addition does nothing to enhance its absorption (if not, then FML).
The downside to arguing on a message board is that the greater majority of people reading can be misled/confused/amazed by one poster randomly citing pubmed as a defense without any appreciation/understanding of what the actual article discusses. I guess this is where the idiom "pubmed ninja" came from. Unfortunately, my patience has grown thin of repeating the same concepts ad nauseum, and thus I will make my exit
....OK i'll probably be back if NO HYPE continues to rambletwitter: @bullexinferis
-
06-26-2010, 10:23 AM #74
I have noticed an interesting trend. The 'pubmed ninja' is indeed real. Anyone can just go to pubmed and pull random studies using keywords, but you actually have to know what you are talking about if you want to explain it to others. Most of the stuff neuron posted was way over my head, but I can tell he understands this stuff and is being frustrated by NO HYPE who keeps popping up with seemingly irrelevant studies.
-
06-26-2010, 11:42 AM #75
- Join Date: Mar 2010
- Location: toronto, ontario, Canada
- Age: 44
- Posts: 181
- Rep Power: 201
so basically from a non genius perspective
neuron
once saturated their is no proof that creatine nitrates are more beneficial then creatine mono
nohype
in theory their are physical benefits yet to be proven with creatine nitrates which makes it a better form of creatine in theory.
conclusion
so basically without more studies done stick with mono until their is more further testing because it can possibly be another creatine ethyl ester or kre alkalyn (which i did buy on the hype) with no additional benefit.I will not fall,
I will not break,
I will take your breath away
-
06-26-2010, 11:56 AM #76
-
-
06-26-2010, 12:01 PM #77
-
06-26-2010, 12:07 PM #78
NO HYPE: There is clinical proof that nitrates = vasodilation. Believes Creatine + Nitrates are better than mono. While no studies yet on creatine nitrate, 1+1 still = 2
Neuron: While other forms of creatine looked good on paper and in theory, when tested against mono it did not perform any better. Until it is tested and performs better with end results that count ie LBM, strength, and not ones that don't count like reaching saturation quicker, no one should make statements that anything is better than mono.
Would like Bane and Neuron to go at it now (of course without insults)
-
06-26-2010, 12:10 PM #79
^^^^^^^
I'm pretty sure he feels the same as the bolded above. This has been the debate about all forms of creatine vs mono.
Not only this but also cost to benefit ratio. Mono is dirt cheap, and if the others cost quite a bit more, their results should be just as much more than mono, yet they have proven to be no better than CrM.
-
06-26-2010, 12:42 PM #80
You're blatantly missing the point here. Everyone knows that Creatine is Creatine.
Arguing over the superiority of a Creatine is simply ignorant because once your muscles are saturated it doesn't take much to keep them saturated, the form of Creatine you're using is irrelevant.
However, simply for the fact that Creatine Nitrate (IE: C-BOL) provides betters pumps than ALL "pump" products currently on the market at the moment, I don't mind spending more for it.
-
-
06-26-2010, 12:45 PM #81
-
06-26-2010, 12:49 PM #82
-
06-26-2010, 12:50 PM #83
-
06-26-2010, 12:54 PM #84
-
-
06-26-2010, 01:03 PM #85
http://www.ncbi.nlm.nih.gov/pubmed/19228401
It does convert faster to creatinine than Monohydrate, however (to some degree) it still does provide the same benefits as mono if used in larger quantities.
But once again, I'm not here to defend CEE, my point was simply that [generally] the type of Creatine you're using doesn't matter as the end result is the same.
However, like I mentioned previously, the pumps I get while on Creatine Nitrate make it totally worth it for me.
-
06-26-2010, 01:04 PM #86
What point am I missing?
For me creatine nitrate will mean nothing to me if it doesn't surpass mono in end markers that count. It can give me the greatest pumps in the world but unless it is significantly better than mono in LBM, and strength there is no reason for me use it, let alone pay 80x more for it.
Creatine Nitrate is promising and I'm sure TL will do a study. Its just to early to praise it as the best thing when it hasn't proven anything besides check the log reviews. Why all the arginine hate now? When not too long ago the check the log reviews were just as great as C-Bol's? Yes their is clinical evidence but like neuron said sometimes it may look good on paper and theory but it doesn't work out.
Again it is promising but its too early to pass anything as fact and truth.
-
06-26-2010, 01:11 PM #87
If you understood the mechanism of Creatine you'd see that comparing different forms and trying to find which one is better in "LBM and strength" is completely ridiculous.
As I previously mentioned, Creatine is Creatine. People use different forms of it for different reasons, so of course stick with what works for you. Personally, having tried both Creatine Mono and Creatine Nitrate, I've noticed a significant difference in pumps, which as I said, makes it worthwhile for me.
-
06-26-2010, 01:34 PM #88
I understand that creatine is creatine. Once saturated it doesn't matter what kind you use. As stated I would not personally pay ALOT extra just for pumps if it isn't better in LBM and strength.
This was from Will Brink and Alan Aragon I believe, and it only made sense to me. Why pay for something that cost alot more when it doesn't give you any better LBM or strength. Why toute something as better when those end markers aren't any better than CrM.
If people buy it for the pumps, thats cool thats their decision. As for me if it doesn't significantly outperform something that is alot cheaper then I don't want to waste my money. According to NO HYPE I believe Nitrates are suppose to help with endurance and strength. If it outperforms straight mono, I'm all for it.
-
-
06-26-2010, 01:36 PM #89
One year ago I'd wind up in a 10 page flamed argument but I seem to have no interest in this, what with 90% of the members I enjoyed talking to getting banned my life getting a whole more interesting e.t.c.
We already have the data from the in vitro studies of creatine nitrate vs mono and X and the data is EXTREMELY positive, will be published in the international journal of pharmaceutical analysis soon.
We also have a big human study on the way where all safety parameters will be measured and well, once again Popeye is still alive.
That's all from me folks , enjoy your Saturday night, I know I will
-
06-26-2010, 01:45 PM #90
Similar Threads
-
creatine elixor any good or not?
By Jerry1351 in forum SupplementsReplies: 1Last Post: 08-13-2004, 08:16 AM -
Maxxon whey/creatine bar. ANY GOOD?
By Mentor7 in forum Product Reviews - Help Out!Replies: 4Last Post: 03-22-2003, 03:25 PM -
Maxxon creatine bar- Any good?
By Mentor7 in forum Teen BodybuildingReplies: 0Last Post: 03-08-2003, 06:40 PM -
Is creatine serum any good?
By hiwaywu in forum Teen BodybuildingReplies: 7Last Post: 09-25-2002, 01:44 AM -
Diamaxx Creatine Serum +? Any Good??
By NItro in forum SupplementsReplies: 4Last Post: 02-22-2002, 07:05 AM
Bookmarks