{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T08:25:12Z","timestamp":1759479912199,"version":"3.41.2"},"reference-count":57,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,9,22]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">In this double\u2010blind randomized placebo\u2010controlled crossover trial, we investigated whether oral sodium nitrate, when added to existing background medication, reduces exertional ischemia in patients with angina.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Seventy patients with stable angina, positive electrocardiogram treadmill test, and either angiographic or functional test evidence of significant ischemic heart disease were randomized to receive oral treatment with either placebo or sodium nitrate (600\u00a0mg; 7\u00a0mmol) for 7 to 10\u00a0days, followed by a 2\u2010week washout period before crossing over to the other treatment (n=34 placebo\u2010nitrate, n=36 nitrate\u2010placebo). At baseline and at the end of each treatment, patients underwent modified Bruce electrocardiogram treadmill test, modified Seattle Questionnaire, and subgroups were investigated with dobutamine stress, echocardiogram, and blood tests. The primary outcome was time to 1\u00a0mm\n              <jats:styled-content style=\"fixed-case\">ST<\/jats:styled-content>\n              depression on electrocardiogram treadmill test. Compared with placebo, inorganic nitrate treatment tended to increase the primary outcome exercise time to 1\u00a0mm\n              <jats:styled-content style=\"fixed-case\">ST<\/jats:styled-content>\n              segment depression (645.6 [603.1, 688.0] seconds versus 661.2 [6183, 704.0] seconds,\n              <jats:italic>P<\/jats:italic>\n              =0.10) and significantly increased total exercise time (744.4 [702.4, 786.4] seconds versus 760.9 [719.5, 802.2] seconds,\n              <jats:italic>P<\/jats:italic>\n              =0.04; mean [95% confidence interval]). Nitrate treatment robustly increased plasma nitrate (18.3 [15.2, 21.5] versus 297.6 [218.4, 376.8] \u03bcmol\/L,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001) and almost doubled circulating nitrite concentrations (346 [285, 405] versus 552 [398, 706] nmol\/L,\n              <jats:italic>P<\/jats:italic>\n              =0.003; placebo versus nitrate treatment). Other secondary outcomes were not significantly altered by the intervention. Patients on antacid medication appeared to benefit less from nitrate supplementation.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Sodium nitrate treatment may confer a modest exercise capacity benefit in patients with chronic angina who are taking other background medication.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Clinical Trial Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              <jats:styled-content style=\"fixed-case\">URL<\/jats:styled-content>\n              :\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\/\">https:\/\/www.clinicaltrials.gov\/<\/jats:ext-link>\n              . Unique identifier:\n              <jats:styled-content style=\"fixed-case\">NCT<\/jats:styled-content>\n              02078921. Eudra\n              <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>\n              number: 2012\u2010000196\u201017.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.117.006478","type":"journal-article","created":{"date-parts":[[2017,9,9]],"date-time":"2017-09-09T00:10:30Z","timestamp":1504915830000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Inorganic Nitrate in Angina Study: A Randomized Double\u2010Blind Placebo\u2010Controlled Trial"],"prefix":"10.1161","volume":"6","author":[{"given":"Konstantin","family":"Schwarz","sequence":"first","affiliation":[{"name":"School of Medicine &amp; Dentistry, University of Aberdeen, Aberdeen, UK"},{"name":"Royal Wolverhampton Hospital, Wolverhampton, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satnam","family":"Singh","sequence":"additional","affiliation":[{"name":"School of Medicine &amp; Dentistry, University of Aberdeen, Aberdeen, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satish K.","family":"Parasuraman","sequence":"additional","affiliation":[{"name":"School of Medicine &amp; 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