Bmj Usa: Minerva


BMJ 2003; 327 doi: (Published 19 November 2003) Cite this as: BMJ 2003;327:E136

From BMJ USA 2002;August:462

Why does glyceryl trinitrate alleviate angina in some people, though its benefits quickly wear off in others? The secret apparently lies in an enzyme called mitochondrial aldehyde dehydrogenase. Scientists reporting in the (Proceedings of the National Academy of Sciences 2002;99:8306–8311) say the enzyme transforms nitroglycerin within mitochondria (potentially affecting other drugs taken at the same time) and is also destroyed by nitroglycerin, interfering with cells' ability to function.

It's not always easy to convince patients to take medicine as it's prescribed. For some conditions how regularly the drugs are taken makes little difference, but for HIV it can mean the difference between life and death. A population based analysis of almost 1300 HIV positive individuals who started triple combination therapy in 1996 shows that, even after adjustment for other prognostic factors, those who took antiretroviral therapy intermittently were almost three times more likely to have died by 2000 (AIDS 2002;16:1051–1058).

Another condition where compliance can be critical is diabetes. A retrospective cohort study set in Scotland discovered that adequate adherence to a single prescribed oral hypoglycemic agent was found …

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